| Acute leukemia complicated with diabetes mellitus (DM) is not clinically uncommon. Based on the domestic and foreign studies, hyperglycemia has been shown to be an independent predictor of adverse outcomes among hospitalized patients with undiagnosed DM. The purpose of the current study is to know the clinical characteristics, blood glucose metabolism changes and its clinical meanings in acute leukemia complicated with DM, and to elucidate the pathogenesis mechanism of the glucose metabolism disorders, and to determine its effect on survial, duration of disease remission and treat-related complications.Methods : Now we have a comparative analysis of two groups adult patients during the period from 1996 to 2004 in our hospital. One group is 39 patients diagnosed (DM group), the other group is 31 patients with leukemia from simple random sampling (control group). In DM group, there are 23 male and 16 female patients. The proportion of male and female is 1.44:1. The mean age is 53.7±13.2 years old.The formation of leukemia is 26 AML patients (M1 2,M2 7, M3 8,M4 5,M5 2, M6 2) and 13 ALL patients. In control group, there are 18 male and 13 female patients. The proportion of male and female is 1.4:1. The mean age is 43.4±10.7 years old . The formation of leukemia is 22 AML patients (M1 1,M2 6,M3 9,M4 2,M5 2,M62) and 9 ALL patients. The chemotherapy regimen and supportive therapy of leukemia in two groups are similar. In DM group, the blood glucose is controlled respectively by diet control ,oral drugs and insulin. Difference between the two groups were assessed using standard statistical methods.Results:(1)The ages of DM group are older than the control group(P<0.001).The weight index of the two groups had no difference (P>.05)(2)In DM group,occurrence time of DM is seen in the following cases: 1) 19 patients are diagnosed with DM before the initial chemotherapy, including 20 patients. 2) Patients with DM history are composed of 8 patients. 3) hyperglycemia of 7 patients appears at the leukemia recurdescence stage. 4) Diabetes of 3 patients occurs at the bone marrow suppression stage, among them 2 patients had DM after 14 days therapy of prednisone and L-asparaginase and 1 patients after he had the heart failure and infiltration of large amouts of the leukemic cell.5) 2 patients had DM during the chemotherapy remission stage.(3)clinical presentations:1)8 patients had hypermeta- bolism symptoms group: hyperdipsia,hyperphagia and weight loss and so on, among them 2 patients had the diabetic ketoacidosis. And 1 patient treated by insulin had suffered from hypoglycemia. 2) 20 patients had infection in DM group. The common infection in DM group include sepsis(17.9%),fungal infection and the respiratory system infection (15.4%), acute gastroenteritis (12.8%) and perianal infection,soft tissue cellulitis and infective shock(respectively 5.1%) and cholecystitis(2.6%), whereas 6 patients in control group had infections .The infection incidence rate of DM group is higher than the control group (P<0.05). 3)The incidence rate of spenomegaly in DM groups is higher than that in control group, while the incidence rate of hepatomegaly,lymph node enlargement and central nervous system leukemia are similar between the two groups. (4) Lab examination : 1)Compared to the control group, DM group have higher amounts of peripheral WBC counts,the peripheral blast cells counts and the peripheral blast cells percent. The rate of peripheral WBC counts >20.0×109/L in DM group are mostly is higher than that in control group.There is no difference in the HGB amounts and PLT counts between the two groups. 2) In DM group, blast cells in the bone marrow is conspicuously higher (P<0.05).3) The blood glucose levels of DM group are obviously higher than that of the control group(P<0.001).The blood glucose levels of the patients in DM group who died during the chemotherapy is higher than the lived patients(P<0.05). The blood glucose levels of the infected patients in DM group is higher than the noninfected patients (P<0.05). (5) T...
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