The American Society of Clinical Oncology 2024 Annual Meeting recently featured a study that showed a noteworthy incidence of hyperglycemia in patients with early-stage breast cancer after chemotherapy. The Vagelos College of Physicians and Surgeons at Columbia University conducted the research, which used Continuous Glucose Monitors and emphasizes the effects of hyperglycemia on patient outcomes and treatment success.
Increasing Rate of Breast Cancer
In the United States, the incidence of breast cancer has increased by about 0.5% year over the last forty years. Twenty-five percent of all new cancer diagnoses in the US as of 2024 were female breast cancer cases, with 310,720 new cases in total. With a current five-year survival rate of 91.2%, breast cancer mortality rates have been gradually declining despite the rising incidence.
Diabetes and Breast Cancer
Elevated blood sugar levels, often known as hyperglycemia, are known to raise the risk of breast cancer. Moreover, hyperglycemia might raise breast cancer patients’ mortality and have a detrimental effect on the effectiveness of treatment. Nevertheless, it was previously unknown what patterns and how common hyperglycemia was during chemotherapy in individuals with early-stage breast cancer.
Study Synopsis
Using continuous glucose monitoring and Continuous Glucose Monitors, researchers at Columbia University performed a prospective, single-arm pilot trial to determine the prevalence of hyperglycemia in patients with early-stage breast cancer undergoing chemotherapy. Study participants included twenty adult patients receiving weekly paclitaxel and trastuzumab, docetaxel/cyclophosphamide, and other chemotherapy regimens.
Techniques
From the time chemotherapy started until the end of their treatment, patients wore Continuous Glucose Monitors. Finding out how common hyperglycemia was and how much time people spent in it were the study’s main goals. The baseline prevalence of prediabetes and diabetes, as well as changes in A1c levels from baseline to weeks 12 and 24, were secondary objectives.
Baseline Results
Ten patients were euglycemic, seven had prediabetes, and three had diabetes at the beginning of the trial. For the trial, hyperglycemia developed in every subject. 17% of the 124,165 Continuous Glucose Monitors readings analyzed had a glucose level of 140 mg/dL or higher, with an average of 112.7 mg/dL.
Patterns of Hyperglycemia
Individuals with prediabetes (10%) and euglycemic patients (3.9%), in order of frequency of hyperglycemia, were patients with diabetes (73.3%). At 183.0 mg/dL, the average glucose levels in the diabetes group were also the highest, compared to 104.5 mg/dL in the prediabetes group and 95.5 mg/dL in the euglycemic group. The groups’ mean A1c changes from baseline to weeks 12 and 24 differed considerably.
Consequences and Suggestions
According to the study’s findings, hyperglycemia was common among all chemotherapy-treated early-stage breast cancer patients, with notable differences depending on the patient’s baseline A1c levels. These results imply that patients whose baseline A1c values are higher than 5.7% may benefit from better glucose control.
To evaluate the advantages of improved glucose management in this patient population, the researchers stressed the necessity for further therapies. Targeted methods to keep glucose levels within a healthy range should improve treatment outcomes and overall survival rates, as hyperglycemia can reduce the effectiveness of chemotherapy and raise the risk of mortality.
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FAQs
For patients with breast cancer, why is it vital to monitor their glucose levels?
Because hyperglycemia increases the risk of problems and can significantly impact the effectiveness of chemotherapy, it is imperative to monitor glucose levels. Sustaining ideal glucose levels can enhance general health and treatment results.
What are the advantages of Continuous Glucose Monitors for chemotherapy patients?
Chemotherapy and other therapies can produce glucose variations, which Continuous Glucose Monitors can assist patients and their healthcare providers monitor. To maintain stable glucose levels and improve treatment efficacy, this data enables prompt dietary, pharmaceutical, and lifestyle modifications.
Do some forms of chemotherapy have a greater impact on glucose levels than others?
Indeed, there is a higher likelihood of glucose swings with some treatment regimens. The effect varies according to the medications used, the health of the patient, and the patient’s response to treatment.
For patients with CGM-assisted breast cancer, what are the usual glucose targets?
Although there are differences in glucose objectives, the basic objective is to maintain blood sugar levels in a range that prevents hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar). Personalized goals should take into account the patient’s overall health and course of treatment.
How frequently should a patient undergoing chemotherapy have their glucose levels monitored using CGM?
Continuous Glucose Monitors or CGMs provide real-time data by continually monitoring blood glucose levels. To make sure they stay within goal ranges, patients usually check their readings several times a day, particularly before meals, after exercising, and right before taking medications.
Can CGM devices notify users when their blood sugar levels are dangerous?
It is possible to program Continuous Glucose Monitors to notify patients when their blood glucose levels are abnormally high or low. Patients who receive these notifications are better able to promptly manage their blood sugar levels and prevent problems.
How many patients with breast cancer benefit from CGM data in terms of food and lifestyle management?
Understanding how various diets, activities, and stresses affect glucose levels is possible with the help of CGM data. To maintain stable glucose levels, patients can utilize this information to modify their food and lifestyle, which is essential for both their general health and the efficacy of their medication.
Are there any dangers involved in breast cancer patients utilizing CGM?
The main limited hazards of Continuous Glucose Monitors are the requirement to calibrate the device regularly and the possibility of skin irritation at the sensor site. Nevertheless, the advantages of regularly checking blood sugar levels usually exceed these little hazards.
Do people with breast cancer have insurance that covers CGMs?
Continuous Glucose Monitors coverage differs depending on the insurance company and the policy. Patients should inquire about their insurance plan’s coverage of CGMs and any necessary paperwork from the insurance provider.
How do patients begin using CGM?
Patients should discuss CGM with their physician if they are interested. The healthcare professional can recommend Continuous Glucose Monitors, teach the patient how to use them and assist in incorporating them into their overall treatment strategy.
In Summary
The study emphasizes how important it is to keep an eye on and control blood glucose levels in patients with early-stage breast cancer receiving chemotherapy. The utilization of continuous glucose monitoring has demonstrated efficacy in detecting trends of hyperglycemia and customizing therapies accordingly. With the number of cases of breast cancer increasing, it may be possible to improve patient survival rates and quality of life by incorporating diabetes technologies and tailored glucose management into cancer care procedures.
