Prospective Evaluation of the Effect of a Manual for Diabetic Patients who Receive Cancer Chemotherapy

ABSTRACT Background How to safely administer cancer chemotherapy to patients with diabetes mellitus is an important issue. Our institution is a general core hospital in Japan. In 2010, we surveyed the current status of diabetic patients given cancer chemotherapy. Adequate medical examinations were not performed. In 2011, we designed a manual for diabetic patients who receive cancer chemotherapy. We now report an improvement in medical examinations of diabetic patients who receive cancer chemotherapy since introducing our manual. Methods We decided that adequate medical examinations should include the following: adequate measurement of blood sugar levels; evaluation of the patient by a diabetologist; making standards for decreasing the dose of steroids given before cancer chemotherapy; and making standards for nutritional guidance. We compared the present status (as of March 2012) with that before the introducing our manual for diabetic patients receiving cancer chemotherapy. Results The proportion of diabetic patients increased from 12% to 19%. The rate of measuring blood sugar levels at the start of new regimens of chemotherapy increased from 69% to 72%. The rate of adequate continuous monitoring of blood sugar levels increased from 48% to 81%. The rate of evaluation by a diabetologist increased from 36% to 50%. The rate of decreased premedication with steroids increased from 55% to 66%. The rate of providing nutritional guidance was unchanged (23% to 24%). Conclusions The rates of adequate continuous monitoring of blood sugar levels, decreasing premedication with steroids, and evaluation by a diabetologist improved. The increase in the proportion of diabetic patients was attributed to adequate blood sugar examinations. However, the low rate of providing of nutritional guidance remains an unsolved problem. Disclosure All authors have declared no conflicts of interest.