Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Apr 15, 2024; 15(4): 645-653
Published online Apr 15, 2024. doi: 10.4239/wjd.v15.i4.645
Influence of blood glucose fluctuations on chemotherapy efficacy and safety in type 2 diabetes mellitus patients complicated with lung carcinoma
Tian-Zheng Fang, Xian-Qiao Wu, Ting-Qi Zhao, Shan-Shan Wang, Guo-Mei-Zhi Fu, Qing-Long Wu, Cheng-Wei Zhou
Tian-Zheng Fang, Xian-Qiao Wu, Guo-Mei-Zhi Fu, Qing-Long Wu, Cheng-Wei Zhou, Department of Thoracic Surgery, The First Affiliated Hospital of Ningbo University, Ningbo 315020, Zhejiang Province, China
Ting-Qi Zhao, Department of Endocrine, The First Affiliated Hospital of Ningbo University, Ningbo 315020, Zhejiang Province, China
Shan-Shan Wang, Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Ningbo University, Ningbo 315020, Zhejiang Province, China
Co-first authors: Tian-Zheng Fang and Xian-Qiao Wu.
Author contributions: Fang TZ and Wu XQ contributed equally to this work and are co-first authors; Fang TZ, Wu XQ and Zhou CW conceived and designed the study; Fang TZ, Wu XQ, Zhao TQ, Wang SS, Fu GMZ, Wu QL and Zhou CW guided the study; Fang TZ, Wu XQ collected the clinical date; Fang TZ, Wu XQ and Zhou CW analyzed the data; and all authors drafted and revised the manuscript.
Supported by Chronic Disease Management Center for Thoracic Tumor, The Affiliated Hospital of Medical School of Ningbo University, No. 2021MGZX-07; and Natural Science Foundation of Ningbo, No. 2019A610238.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of the First Affiliated Hospital of Ningbo University.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cheng-Wei Zhou, MM, Doctor, Department of Thoracic Surgery, The First Affiliated Hospital of Ningbo University, No. 247 Renmin Road, Jiangbei District, Ningbo 315020, Zhejiang Province, China. nbzhouchengwei@163.com
Received: November 21, 2023
Peer-review started: November 21, 2023
First decision: December 5, 2023
Revised: December 15, 2023
Accepted: February 21, 2024
Article in press: February 21, 2024
Published online: April 15, 2024
Processing time: 142 Days and 16.3 Hours
Abstract
BACKGROUND

Patients with type 2 diabetes mellitus (T2DM) have large fluctuations in blood glucose (BG), abnormal metabolic function and low immunity to varying degrees, which increases the risk of malignant tumor diseases and affects the efficacy of tumor chemotherapy. Controlling hyperglycemia may have important therapeutic implications for cancer patients.

AIM

To clarify the influence of BG fluctuations on chemotherapy efficacy and safety in T2DM patients complicated with lung carcinoma (LC).

METHODS

The clinical data of 60 T2DM + LC patients who presented to the First Affiliated Hospital of Ningbo University between January 2019 and January 2021 were retrospectively analyzed. All patients underwent chemotherapy and were grouped as a control group (CG; normal BG fluctuation with a mean fluctuation < 3.9 mmol/L) and an observation group (OG; high BG fluctuation with a mean fluctuation ≥ 3.9 mmol/L) based on their BG fluctuations, with 30 cases each. BG-related indices, tumor markers, serum inflammatory cytokines and adverse reactions were comparatively analyzed. Pearson correlation analysis was performed to analyze the correlation between BG fluctuations and tumor markers.

RESULTS

The fasting blood glucose and 2-hour postprandial blood glucose levels in the OG were notably elevated compared with those in the CG, together with markedly higher mean amplitude of glycemic excursions (MAGE), mean of daily differences, largest amplitude of glycemic excursions and standard deviation of blood glucose (P < 0.05). In addition, the OG exhibited evidently higher levels of carbohydrate antigen 19-9, carbohydrate antigen 125, carcinoembryonic antigen, neuron-specific enolase, cytokeratin 19, tumor necrosis factor-α, interleukin-6, and high-sensitivity C-reactive protein than the CG (P < 0.05). Pearson analysis revealed a positive association of MAGE with serum tumor markers. The incidence of adverse reactions was significantly higher in the OG than in the CG (P < 0.05).

CONCLUSION

The greater the BG fluctuation in LC patients after chemotherapy, the more unfavorable the therapeutic effect of chemotherapy; the higher the level of tumor markers and inflammatory cytokines, the more adverse reactions the patient experiences.

Keywords: Blood glucose fluctuation; Type 2 diabetes mellitus; Lung carcinoma; Tumor markers

Core Tip: Controlling hyperglycemia may have important therapeutic implications for cancer patients. In this study, we seek to clarify the influence of blood glucose fluctuations on chemotherapy efficacy and safety in type 2 diabetes mellitus patients complicated with lung carcinoma.