Impaired fasting glucose, male sex up risk for diabetes in cancer patients

Some patients receiving chemotherapy with dexamethasone develop diabetes, and this risk is especially prominent in men and in the presence of impaired fasting glucose, according to a study.

The multicentre, observational cohort study involved 299 adult breast or colorectal cancer patients (mean age 51 years) scheduled to receive four to eight cycles of adjuvant chemotherapy that included steroids. They were followed for a mean of 39 months.

Of the patients, 17 (6.3 percent) developed diabetes mellitus over a median follow-up of 90 days (range, 17–359).

In multivariable Cox models, two factors showed an independent association with the risk of new-onset diabetes. These were male sex (hazard ratio [HR], 15.839, 95 percent confidence interval [CI], 2.004–125.20) and impaired fasting glucose at baseline (HR, 8.307, 95 percent CI, 1.826–37.786).

At 6 months following completion of chemotherapy, 11 out of 17 patients (64.7 percent) achieved diabetes remission. Those who did versus did not experience remission had significantly elevated C-peptide levels at baseline (1.3 vs 0.9 ng/mL).

Elevated C-peptide levels at baseline emerged as a significant predictor of diabetes remission (age- and sex-adjusted, p=0.007).

The findings highlight the importance of close monitoring for hyperglycaemia, especially for men with impaired fasting glucose.