A nurse‐led intervention in patients with newly diagnosed cancer and Type 2 diabetes: A pilot randomized controlled trial feasibility study

Author:

Scarton Lisa1ORCID,Nelson Tarah1ORCID,Jo Ara2,O’Neal LaToya J.3,Yao Yingwei1,Huggins Shavondra1,Legaspi Anatolia B.4,McClaren Mariah J.1,Cabassa Jake S.1,Burgos Melendez Joan M.1,Munoz‐Pena Juan M.5,Markham Merry J.6,Murphy Martina C.6,Chatzkel Jonathan A.6,Rogers Sherise6,George Thomas J.6ORCID

Affiliation:

1. College of Nursing University of Florida Gainesville Florida USA

2. College of Public Health and Health Professions University of Florida Gainesville Florida USA

3. College of Agricultural and Life Sciences, Institute of Food and Agricultural Sciences University of Florida Gainesville Florida USA

4. College of Pharmacy University of Florida Gainesville Florida USA

5. Division of Endocrinology, Diabetes and Metabolism University of Florida College of Medicine Gainesville Florida USA

6. Division of Hematology and Oncology University of Florida, College of Medicine Gainesville Florida USA

Abstract

AbstractBackgroundUndiagnosed Type 2 diabetes (T2D) has been associated with advanced stage cancer at diagnosis, higher mortality, and lower long‐term all‐cause survival. This was a RCT pilot study to examine the feasibility of a nurse‐led T2D intervention for adults with newly diagnosed cancer (≤3 months), and T2D, undiagnosed or untreated with medication, conducted at an outpatient oncology clinic affiliated with a large academic institution.MethodsParticipants needed to meet the eligibility criteria including a HbA1c level between 6.5% and 9.9%. Randomization was 1:1 to a 3‐month intervention that consisted of nursing‐led diabetes education and immediate initiation of metformin versus referral to primary care for usual care (control).ResultsThree hundred and seventy nine patients were screened using EHR, 55 agreed to participate, and 3 had eligible HbA1c levels and were randomized in the study. Primary reasons for study exclusion included life expectancy ≤2 years (16.9%), current use or inability to tolerate metformin (14.8%), and abnormal labs that contraindicated metformin use (13.9%).ConclusionThis study was not feasible due to recruitment inefficiencies, but acceptable to all who qualified.

Funder

National Cancer Institute

Publisher

Wiley

Subject

Cancer Research,Radiology, Nuclear Medicine and imaging,Oncology

Reference18 articles.

1. US Department of Health and Human Services Centers for Disease Control and Prevention.National Diabetes Statistics Report website. Updated June 29 2022. Accessed November 21 2022.https://www.cdc.gov/diabetes/data/statistics‐report/index.html

2. Epidemiology and outcomes of previously undiagnosed diabetes in older women with breast cancer: an observational cohort study based on SEER-Medicare

3. Significantly Increased Risk of Cancer in Patients with Diabetes Mellitus: A Systematic Review and Meta-Analysis

4. Long-term All-Cause Mortality in Cancer Patients With Preexisting Diabetes Mellitus

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