A Pilot Study Evaluating Steroid-Induced Diabetes after Antiemetic Dexamethasone Therapy in Chemotherapy-Treated Cancer Patients.
- Author:
Yusook JEONG
1
;
Hye Sook HAN
;
Hyo Duk LEE
;
Jiyoul YANG
;
Jiwon JEONG
;
Moon Ki CHOI
;
Jihyun KWON
;
Hyun Jung JEON
;
Tae Keun OH
;
Ki Hyeong LEE
;
Seung Taik KIM
Author Information
- Publication Type:Original Article
- Keywords: Antiemetics; Drug therapy; Dexamethasone; Diabetes mellitus
- MeSH: Antiemetics; Blood Glucose; Dexamethasone*; Diabetes Mellitus; Diagnosis; Drug Therapy; Fasting; Gastrointestinal Neoplasms; Glucose; Homeostasis; Humans; Incidence; Insulin; Insulin Resistance; Multivariate Analysis; Nausea; Pilot Projects*; Vomiting
- From:Cancer Research and Treatment 2016;48(4):1429-1437
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: Dexamethasone is a mainstay antiemetic regimen for the prevention of chemotherapy-induced nausea and vomiting. The aim of this pilot study was to assess the incidence of and factors associated with steroid-induced diabetes in cancer patients receiving chemotherapy with dexamethasone as an antiemetic. MATERIALS AND METHODS: Non-diabetic patients with newly diagnosed gastrointestinal cancer who received at least three cycles of highly or moderately emetogenic chemotherapy with dexamethasone as an antiemetic were enrolled. Fasting plasma glucose levels, 2-hour postprandial glucose levels, and hemoglobin A1C tests for the diagnosis of diabetes were performed before chemotherapy and at 3 and 6 months after the start of chemotherapy. The homeostasis model assessment of insulin resistance (HOMA-IR) was used as an index for measurement of insulin resistance, defined as a HOMA-IR ≥ 2.5. RESULTS: Between January 2012 and November 2013, 101 patients with no history of diabetes underwent laboratory tests for assessment of eligibility; 77 of these patients were included in the analysis. Forty-five patients (58.4%) were insulin resistant and 17 (22.1%) developed steroid-induced diabetes at 3 or 6 months after the first chemotherapy, which included dexamethasone as an antiemetic. Multivariate analysis showed significant association of the incidence of steroid-induced diabetes with the cumulative dose of dexamethasone (p=0.049). CONCLUSION: We suggest that development of steroid-induced diabetes after antiemetic dexamethasone therapy occurs in approximately 20% of non-diabetic cancer patients; this is particularly significant for patients receiving high doses of dexamethasone.
