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

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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.

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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.

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Authors and Affiliations

  1. Oncological Endocrinology Unit, Department of Medical Sciences, AOU Città della Salute e della Scienza di Torino, Via Genova 3, 10126, Turin, Italy

    Marco Gallo

  2. Endocrinology and Diabetes Unit, Cardinal Massaja Hospital, Asti, Italy

    Luigi Gentile

  3. School of Medicine, University of Turin, Turin, Italy

    Emanuela Arvat

  4. Head of the Piemonte and Valle d’Aosta Oncology Network, Turin, Italy

    Oscar Bertetto

  5. Institute of Food Science, National Research Council, IRPPS - Institute for Research on Population and Social Policies, Penta di Fisciano, Salerno, Italy

    Gennaro Clemente

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  1. Marco Gallo
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  2. Luigi Gentile
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  3. Emanuela Arvat
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  4. Oscar Bertetto
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  5. Gennaro Clemente
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Corresponding author

Correspondence to Marco Gallo.

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Additional information

Managed by Massimo Federici.

On behalf of the AMD - Associazione Medici Diabetologi “Diabetes and Cancer” working group.

In collaboration with the Expert Panel for the Foundation of an Oncology and Endocrine Network in the Piemonte-Valle d’Aosta Regions (see “Appendix”).

Appendix

Appendix

Members of the “Expert Panel for the Foundation of an Oncology and Endocrine Network in the Piemonte-Valle d’Aosta Regions”:

  • Mario Airoldi, M.D., 2nd Medical Oncology, AOU Città della Salute e della Scienza, Turin, Italy; President of the Piemonte and Valle d’Aosta Section of AIOM – Associazione Italiana di Oncologia Medica

  • Enrico Brignardello, M.D., Transition Unit for Childhood Cancer Survivors, Department of Oncology, AOU Città della Salute e della Scienza di Torino, Turin, Italy

  • Alessandro Comandone, M.D., Medical Oncology, Gradenigo Hospital, Turin, Italy

  • Francesco Felicetti, M.D., Transition Unit for Childhood Cancer Survivors, Department of Oncology, AOU Città della Salute e della Scienza di Torino, Turin, Italy

  • Concetta Finocchiaro, M.D., Department of Clinical Nutrition, AOU Città della Salute e della Scienza, Turin, Italy

  • Paolo Fornengo, M.D., Department of Medical Sciences, AOU Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy

  • Ezio Ghigo, M.D., PhD, Dean of the School of Medicine, University of Turin, Italy

  • Luca Richiardi, M.D., President of the Piemonte and Valle d’Aosta Section of AMD - Associazione Medici Diabetologi

  • Milena Tagliabue, M.D, President of the Piemonte and Valle d’Aosta Section of SID – Società Italiana di Diabetologia

  • Giorgio Valabrega, M.D., Medical Oncology I, Candiolo Cancer Cancer (IRCCS) FPO (Fondazione del Piemonte per l’Oncologia), Candiolo, Italy; Department of Oncology, University of Turin, Turin, Italy.

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Gallo, M., Gentile, L., Arvat, E. et al. Diabetology and oncology meet in a network model: union is strength. Acta Diabetol 53, 515–524 (2016). https://doi.org/10.1007/s00592-016-0839-z

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