Need for specialist care for cancer patients with diabetes

Cancer patients with diabetes need access to specialist diabetes care, a study at The Royal Marsden has revealed. The study was a joint project run by The Royal Marsden and Chelsea and Westminster Hospital NHS Foundation Trust.

The study, published in the British Journal of Diabetes and Vascular Disease, highlights that patients with cancer are at significant risk of complex problems in glucose control and demonstrates the need for diabetes input into oncology units across the UK.

Cancer rates are increased in people with diabetes and there is evidence to show that outcomes from cancer treatment are worse in patients with diabetes. Diabetes management can be complex in many patients who are being treated in hospitals who don’t have access to specialist diabetes teams.

Knowing this, The Royal Marsden, in partnership with Chelsea and Westminster Hospital, has offered specialist support for diabetes since 2009.

In a bid to improve outcomes and tailor resources and treatment better, there has been a need assess the prevalence of diabetes in cancer patients and this study was run to look at this relationship. It looked at the prevalence of diabetes and hyperglycaemia amongst inpatients at The Royal Marsden as well as specific diabetes referrals within this patient group.

The study’s results showed that 11% of inpatients had either diabetes or hyperglycaemia, showing them to be common problems. But the study also revealed that not all patients with elevated blood glucose were recognised immediately as being diabetic. This can lead to complexities of care for patients undergoing surgery or experiencing nutritional difficulties or treatment side effects, such as vomiting all of which can impact on glucose levels.

These findings show that not only is diabetes a common problem for cancer patients in hospital  but that medical and nursing staff require adequate and specialist training in recognition and diagnosis of diabetes in order to administer the best form of treatment, for what can be complex diabetic needs.

Dr Daniel Morganstein, Consultant at Chelsea and Westminster Hospital and lead author of the study said: “For the first time we have we have been able to show the prevalence of diabetes amongst cancer patients in hospital and what this means for their treatment and care. As a common problem, staff must be trained to recognise the signs and as a result, we will see an improvement in patient outcomes.”

The study concluded that patients with diabetes and cancer require access to diabetes specialist care and recommended the input of specialist diabetes teams into oncology units.

Professor Martin Gore, The Royal Marsden’s Medical Director and one of the study’s authors, said: “Cancer patients can often have other health complexities. This study shows how important it is for there to be a linked up approach to patient care between specialist diabetes teams and oncology units.”