Glycemic Variability Within 1 Year Following Surgery for Stage II–III Colon Cancer

Author:

Mandolfo Natalie Rasmussen1ORCID,Berger Ann M.1,Struwe Leeza1,Hanna Kathleen M.1ORCID,Goldner Whitney2,Klute Kelsey3,Langenfeld Sean4,Hammer Marilyn5

Affiliation:

1. College of Nursing, Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE, USA

2. Department of Internal Medicine, Section of Diabetes, Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE, USA

3. Department of Internal Medicine, Division of Oncology & Hematology, Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE, USA

4. Department of Surgery, Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE, USA

5. Dana-Farber Cancer Institute, Boston, MA, USA

Abstract

Objective: To examine glycemic variability within 1 month and 1 year following surgery among adult patients, with and without Type 2 Diabetes (T2D), treated for stage II-III colon cancer. Method: A retrospective analysis of electronic health record data was conducted. Glycemic variability (i.e., standard deviation [SD] and coefficient of variation [CV] of > 2 blood glucose measures) was assessed within 1 month and within 1 year following colon surgery. Chi-square (χ2), Fisher’s exact, and Mann-Whitney U tests were used for the analyses. Results: Among the sample of 165 patients with stage II–III colon cancer, those with T2D had higher glycemic variability compared to patients without T2D ( p < .001), with values within 1 month following surgery (SD = 44.69 mg/dL, CV = 27.4%) vs (SD = 20.55 mg/dL, CV = 17.53%); and within 1 year following surgery (SD = 45.04 mg/dL, CV = 29.04%) vs (SD = 21.36 mg/dL, CV = 18.6%). Associations were found between lower body mass index and higher glycemic variability (i.e., SD [r = −.413, p < .05] and CV [r = −.481, p < .01]) within 1 month following surgery in patients with T2D. Higher preoperative glucose was associated with higher glycemic variability (i.e., SD r = .448, p < .01) within 1 year in patients with T2D. Demographic and clinical characteristics were weakly associated with glycemic variability in patients without T2D. Conclusions: Patients with stage II–III colon cancer with T2D experienced higher glycemic variability within 1 month and within 1 year following surgery compared to those without T2D. Associations between glycemic variability and demographic and clinical characteristics differed by T2D status. Further research in prospective studies is warranted.

Funder

Fred & Pamela Buffett Cancer Center Support Grant

Publisher

SAGE Publications

Subject

Research and Theory

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