| Objective To to make well learn about the incidence of diabetes mellitus in cancer patients with diabetes, To explore the safety and the influencing factors in using GC in patients with diabetes mellitus (DM) or impaired fasting glucose (IFG).Background GC has extensive application in the treatment of cancer. But it can bring out or aggravate DM and even cause patient death directly. The pharmacopoeias of our country and a lot of authoritative works point out clearly that GC can not be used in the DM patient. When the cancer and DM take place to the same patient, there has a sharp conflict between its necessity and risk in using GC. Not any document expounds the fact whether or not GC can be used in cancer patient with DM so far, It is a urgent need to research the safety from evidence based medicine.Materials and method All subjects recruited in the study were selected from in-patients who hospitalized in the First Affliated Hospital of Anhui Medical University from 01/11/2003 to 28/02/2004. The patients with DM were classified as DM group, the patients with IFG were classified as IFG group, Other patients were taken as primary control group and further randomly sampled to match GM group or IFG group according to dosage of GC, sex, and age. The dosage of GC and the chemotherapeutic protocol were determined according to actual demands. Venous blood glucose and capillary glucose were examined regularly. The changes of blood glucose, toxicities and its relative influencing factors after treatment with GC were recorded andevaluated. Serum TNF and IL-6 were determined by enzyme linked immunosorbent assay, the relat ionship between the cytokines and DM mel 1 i tus or IFG were analyzed ultimately.Results 9.95% of DM and 7.31% of IFG taken place in the cancer patients. After using GC and chemotherapy the incidence of nausea, vomitting, abdominal discomfort, headache, insomnia, pneumonia, Hyperhidrosis, palpi tat ion and blood pressure were slightly higher in 29 cases of DM than in control group. Control 1 able hyperglycemia more than one time taken place in 28 cases (97%) and were significant ly higher than the control (Z=6.514 P< 0.01) . Percentage needed to change hypoglycemic agent were higher a little in patients who had not taken hypoglycemic drug (2 / 11) than one who had taken (2/18) . There had also similar results in IFG.To patients with normal blood sugar, 20 cases occurred hyperglycemia in 220 (9.09%) cases who received GC companing with chemotherapy and 4 cases (11.76%) in 34 patients who received only GC. The incidence of hyperglycemia was higher significantly in NP protocol (34.61%) than in CAF (4.76%), FLP (4.76%). EP (3.70%) . The incidence were also influenced by age (>65 VS =$65), dosage of dexamethasone (>5mg VS ^5mg) .The serum level of TNF-a and IL-6 in cancer pat ients wi th DM were higher than pat ients without DM. The level of IL-6 in cancer patients with IFG was higher than patients without IFG.Conclusions The morbidity of DM in cancer patients is high significantly than in general population. But it is safe to use GC for them. Some chemotherapeutic agents, age, dosage of GC and tumor stage may affect the incidence of hyperglycemia when GC and/or chemotherapy were given. Serum...
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