Glycemic control and survival of patients with coexisting diabetes mellitus and gastric or esophageal cancer

Nina J Karlin; Matthew R Buras; Heidi E Kosiorek; Patricia M Verona; Curtiss B Cook

doi:10.2144/fsoa-2019-0038

Glycemic control and survival of patients with coexisting diabetes mellitus and gastric or esophageal cancer

Future Sci OA. 2019 Jun 26;5(6):FSO397. doi: 10.2144/fsoa-2019-0038.

Authors

Nina J Karlin¹, Matthew R Buras², Heidi E Kosiorek², Patricia M Verona³, Curtiss B Cook⁴

Affiliations

¹ Division of Hematology & Medical Oncology, Department of Internal Medicine, Mayo Clinic Hospital, Phoenix, AZ 85054, USA.
² Division of Endocrinology, Department of Biostatistics, Mayo Clinic, Scottsdale, AZ 85259, USA.
³ Department of Information Technology, Department of Biostatistics, Mayo Clinic Hospital, Phoenix, AZ 85054, USA.
⁴ Department of Internal Medicine, Division of Endocrinology, Mayo Clinic, Scottsdale, AZ 85259, USA.

Abstract

Aim: To examine effects of diabetes mellitus (DM) on survival in gastric or esophageal (GE) cancer and the cancers' effects on glycemic control.

Materials & methods: Patients with GE cancer with and without DM were matched 1 to 1 (2006-2016). Characteristics were compared and survival assessed with Kaplan-Meier method and Cox regression. Mixed models compared hemoglobin A_1c and glucose over time.

Results: Among DM cases, mean hemoglobin A_1c was 6.8% in the year after cancer diagnosis. Three-year overall survival was 46% with DM versus 52% without DM (hazard ratio [95% CI]: 1.95 [1.14-3.34]; p = 0.02).

Conclusion: GE cancer and its treatment did not affect glycemic control. Risks of death and progression were greater for patients with DM than patients without DM.

Keywords: cancer; endocrinology; glycemia; malignancy; mortality; outcomes research.