The treatment of diabetes as a complication of pancreatic cancer
You may recall from a previous blog post that pancreatic cancer and diabetes seem to be linked however it’s not clear which is the risk and which the symptom.
Of course, it is even harder for scientists to work out how the two conditions are linked when they share several common risk factors such as:
- Being more common in older age
- Being linked to being obese
- Affected by alcohol and smoking cigarettes
To get some perspective let me be clear that less than 2 in 100 people with diabetes are diagnosed with pancreatic cancer in the 3 years after they are first told about their diabetes and the risk diminishes as time elapses.
A few diabetes patients have been worried about the results of some studies that seemed to indicate that the drugs they take actually increase the risk of pancreatic cancer.
However, it is vital to understand that have been flaws to these studies which are in no way conclusive and what is very clear is that medications are vital for the management of diabetes and that controlling blood sugar levels reduces the risk of pancreatic cancer overall
The management of both conditions
Given that the two conditions are intricately linked I’m sure it will come as no surprise that the management of diabetes when you have pancreatic cancer is extremely challenging because improving one condition can deteriorate the other.
For example If your pancreas is not functioning correctly you will struggle to maintain adequate nutrition. This needs to be actively managed to prevent other ill effects so if you’ve lost weight or are struggling to eat the usual advice about diet and is unlikely to be appropriate.
In order to regain weight, you will be required to take in more calories and eat foods that increase your blood sugar level so the management of your diabetes will have to be around this more urgent requirement. Loss of pancreatic enzymes as a result of surgery mean that you will be prescribed enzyme supplements (Creon) to help absorb your meals but this absorption can be variable so adjusting insulin requirements can be difficult.
You may also be coping with a roller coaster of blood sugar levels. If you are struggling to digest your food and absorb sugar this will obviously give you low blood sugars. However once you take the dextrose based enzyme supplements your blood sugar will start to rise again. Again the management of your diabetes will have to accommodate these changes
Other medications can also cause a see saw effect for example steroids not only increase hepatic glucose production but can also increase insulin resistance. This means insulin doses might have to be increased during treatment and lowered when steroid treatment is discontinued.
Patients with cancer can be overwhelmed by the constant requirement of injections and blood glucose monitoring but unfortunately this is vital to prevent them being hypoglycaemic.
And, of course, patients with diabetes and cancer have an increased risk of infection, kidney problems and problems with the small blood vessels which will delay recovery.
Because of this it is usual for a collaborative relationship to be established with your diabetes care provider with an action plan developed to treat the diabetes during cancer therapy.
Although every effort is made to ensure that all health advice on this website is accurate and up to date it is for information purposes and should not replace a visit to your doctor or health care professional.
As the advice is general in nature rather than specific to individuals Dr Vanderpump cannot accept any liability for actions arising from its use nor can he be held responsible for the content of any pages referenced by an external link.