Keywords: breast cancer,diabetes mellitus,glucose control
Diabetes mellitus (DM) is characterized by various long-term complications, between which association with malignant disorders including breast cancer (BC).
The contribution of DM to development of BC has been discussed widely. In contrast the effect of breast cancer on the management of DM and the control of the disease has not been reported.
How does BC influence on the control of DM?.
A cross sectional study. Included in the study women with DM who were diagnosed with BC.
Demographic data, information related to control of DM, date of onset of BC and related treatments were retrieved from the data base of CHS.
Control of DM was defined as HBA1C<7.5 for women younger than 65y. and <8 for women aged 65 years and older.
Control of DM was evaluated 2 years before and after diagnosis of breast cancer, considering demographic and morbidity factors.
The study population included 220 women with DM who were diagnosed with breast cancer during 2005-2016, 56% of them were Jews. Obesity was recorded in 78% of them. Anxiety was diagnosed in 55% and depression in 43%. Surgical procedures were documented in 87% of the women, radiation in 67%. Oncologic medications were purchased by 31%.
The trend towards controlled DM was reported in 186 women and towards not controlled in 30 women.
According the logistic regression model the factors identified with chance for trend towards controlled DM were: for Arabs less than Jews [OR=0.2, 95% CI 0.09-0.7, p=0.007), older age [OR=1.1, 95%CI 1.06-1.18, p=<0.001] not having mental disorder [OR=0.18, 95% CI 0.06-0.54, p=0.002]
On average diagnosis of BC did not disrupt the control of DM. It is possible that the BC raise the level of self-care. We should focus on younger women, Arabs and those having mental co-morbidity to prevent deterioration of DM.
Points for discussion:
diabetes mellitus co-morbidity.