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Glycemic control in people with diabetes treated with cancer chemotherapy: contribution of continuous glucose monitoring

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Abstract

Aims

The aim of our study was to assess, with Continuous Glucose Monitoring (CGM), exhaustive information on the glucose profile in people with diabetes starting chemotherapy. We also evaluated the adaptation of glucose-lowering drugs following analysis of CGM recordings.

Methods

Eighty-five people with diabetes starting chemotherapy were included in the ONCODIAB study. A CGM was worn for up to fourteen days in blinded mode before and after the diabetologist’s intervention to evaluate the impact of modifying the glucose-lowering drugs.

Results

Time spent in range was 67.2 ± 24.2%. Time below the target glucose range (TBR) (< 70 mg/dl) was 8.9% in all the study population. TBR was significantly higher in patients treated with at least one drug due to the risk of hypoglycemia compared to the others (11.5% vs. 4.4%, p = 0.009). Sixty-five patients had available sensor data for the two recordings. Forty-one patients (51.9%) saw a decrease in their antidiabetic treatment after the diabetologist’s intervention guided by the first CGM recording. We observed a significant reduction in the time spent below the target glucose range (70–55 mg/dl) between the two CGM recordings (10.3 ± 14.6% vs. 6.3 ± 9.4%, p = 0.016 and 3.8 ± 8.4% vs. 1.2 ± 2.9%, p = 0.012, respectively).

Conclusions

CGM use in blinded mode could be an interesting tool to reduce the risk of hypoglycemia in people with diabetes starting chemotherapy. Our findings fully support the recommendation that assessing hypoglycemia risk should be mandatory in patients with diabetes before starting chemotherapy.

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Funding

The authors did not receive support from any organization for the submitted work. No funding was received to assist with the preparation of this manuscript. No funding was received for conducting this study. No funds, grants, or other support was received.

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Authors and Affiliations

  1. Department of Endocrinology, Diabetes and Metabolic Disorders, Dijon University Hospital, Dijon, France

    Pauline Legris, Benjamin Bouillet, Isabelle Simoneau, Pamela Massoud, Alexia Rouland & Jean-Michel Petit

  2. INSERM Unit, LNC-UMR 1231, University of Burgundy, Dijon, France

    Benjamin Bouillet, Alexia Rouland & Jean-Michel Petit

  3. Department of Pharmacy, University Hospital, Dijon, France

    Justine Pâris, Pauline Pistre, Madeline Devaux, Stephanie Bost & Mathieu Boulin

  4. Department of Hepato-Gastroenterology and Digestive Oncology, University Hospital and EPICAD LNC UMR 1231, University of Burgundy & Franche-Comté, Dijon, France

    Sylvain Manfredi & Antoine Drouillard

  5. Department of Clinical Hematology, University Hospital and SAPHIIT UMR 1231, University of Burgundy & Franche-Comté, Dijon, France

    Jean-Noel Bastie

  6. Department of Oncology, University Hospital Dijon, Dijon, France

    Marie Chaix

  7. Hospital Epidemiology and Infection Control Department, Dijon University Hospital, Dijon, France

    Serge Aho

  8. Department of Pharmacy, University Hospital and EPICAD LNC UMR 1231, University of Burgundy & Franche-Comté, Dijon, France

    Mathieu Boulin

  9. Service de Diabétologie, Centre Hospitalier Universitaire François Mitterrand, BP 77908, 21079, Dijon, Cedex, France

    Jean-Michel Petit

Authors
  1. Pauline Legris
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  2. Benjamin Bouillet
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  3. Justine Pâris
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  4. Pauline Pistre
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  5. Madeline Devaux
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  7. Isabelle Simoneau
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  8. Sylvain Manfredi
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  9. Antoine Drouillard
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  10. Jean-Noel Bastie
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  11. Marie Chaix
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  12. Pamela Massoud
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  13. Alexia Rouland
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  14. Serge Aho
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  15. Mathieu Boulin
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  16. Jean-Michel Petit
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Corresponding author

Correspondence to Jean-Michel Petit.

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Legris, P., Bouillet, B., Pâris, J. et al. Glycemic control in people with diabetes treated with cancer chemotherapy: contribution of continuous glucose monitoring. Acta Diabetol 60, 545–552 (2023). https://doi.org/10.1007/s00592-023-02032-z

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  • DOI: https://doi.org/10.1007/s00592-023-02032-z

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