Acta Diabetologica

, Volume 53, Issue 4, pp 515–524 | Cite as

Diabetology and oncology meet in a network model: union is strength

  • Marco Gallo
  • Luigi Gentile
  • Emanuela Arvat
  • Oscar Bertetto
  • Gennaro Clemente
Review Article

Abstract

Diabetes and cancer are increasingly common conditions, and the management of cancer patients with diabetes is often challenging. Diabetes in cancer patients poses several complex clinical issues, including which treatment is suitable to control hyperglycemia, how to better counteract glucocorticoid-induced hyperglycemia, and how to manage nutritional problems of cachectic patients and glucose variability linked to artificial nutrition. A key aspect to consider is the patients’ position on the trajectory of the oncologic disease, both to establish which level of glycemic control should be pursued and to decide the most suitable antidiabetic treatment to recommend. Endocrinologists are rarely involved in the management of patients with advanced cancer. Furthermore, lack of guidelines results in a “trial-and-error” approach, often with suboptimal disease management. Lastly, cancer survivors represent a frequently underestimated category of patients at higher cardiometabolic risk. A practical solution for these challenges lies in the implementation of care networks based on a close partnership and ongoing communication between oncologists, endocrinologists, and nutritionists, placing the patient at the center of the care process. At the same time, universities and scientific societies should play a key role in promoting research into areas of intersection of oncology and endocrinology, in raising awareness of common possibilities of primary and secondary prevention of metabolic and oncologic diseases, as well as specific challenges of managing diabetes and cancer, and proper training of health workers, while also supporting the shared implementation of effective management strategies.

Keywords

Diabetes Cancer Glucocorticoids Artificial nutrition Clinical management Cancer survivors 

Notes

Author’s contribution

The authors hereby declare that the manuscript has not been published before, and it is not under consideration for publication anywhere else. Furthermore, its publication has been approved by all co-authors. All authors have contributed to the scientific work and therefore share collective responsibility and accountability for the results.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer-Verlag Italia 2016

Authors and Affiliations

  1. 1.Oncological Endocrinology Unit, Department of Medical SciencesAOU Città della Salute e della Scienza di TorinoTurinItaly
  2. 2.Endocrinology and Diabetes UnitCardinal Massaja HospitalAstiItaly
  3. 3.School of MedicineUniversity of TurinTurinItaly
  4. 4.Head of the Piemonte and Valle d’Aosta Oncology NetworkTurinItaly
  5. 5.Institute of Food Science, National Research Council, IRPPS - Institute for Research on Population and Social PoliciesPenta di FiscianoSalernoItaly

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