Glycosylated hemoglobin A1c and lack of association with symptom severity in patients undergoing chemotherapy for solid tumors

Marilyn Hammer, Bradley Aouizerat, Brian Schmidt, Frances Cartwright, Fay Wright, Christine Miaskowski

Research output: Contribution to journalArticle

Abstract

Purpose/Objectives: To assess the effects of high blood sugar at the levels of diabetic or prediabetic states during cancer treatment because patients undergoing chemotherapy (CTX) experience multiple symptoms that vary among individuals and may be affected by glucose levels. Design: Descriptive, cross-sectional. Setting: Two comprehensive cancer centers, one Veterans Affairs hospital, and four community-based oncology programs. Sample: 244 outpatients with breast, gastrointestinal, gynecologic, and lung cancers. Methods: Patients completed demographic and symptom questionnaires. Glycosylated hemoglobin A1c (HbA1c) was evaluated to determine diabetic state. Descriptive statistics and one-way analyses of variance were used in the analyses. Main Research Variables: HbA1c, symptom severity scores, patient and clinical characteristics (e.g., age, gender, comorbidities, sociodemographic information, body mass index [BMI], lifestyle factors). Findings: HbA1c results showed 9% of the sample in the diabetic and 26% in the prediabetic state. Patients in the diabetic state reported a higher number of comorbid conditions and were more likely to be African American. Patients in the prediabetic state were older aged. Patients in the diabetic and prediabetic states had a higher BMI compared to nondiabetic patients. No differences in symptom severity or quality-of-life (QOL) scores were found among the three diabetic states. Conclusions: This study is the first to evaluate for associations between diabetic states and symptom severity and QOL scores in patients receiving CTX. This study confirmed that older age, as well as having higher BMI and having multiple comorbidities, were associated with increased mean glycemic levels. Implications for Nursing: Clinicians should assess and identify patients with diabetes or prediabetes undergoing treatment for cancer. Patients who are older aged, those with a high BMI, and those with multiple comorbid conditions may be at increased risk for higher glycemic states.

Original languageEnglish (US)
Pages (from-to)581-590
Number of pages10
JournalOncology Nursing Forum
Volume42
Issue number6
DOIs
StatePublished - Nov 1 2015

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Glycosylated Hemoglobin A
Prediabetic State
Drug Therapy
Neoplasms
Body Mass Index
Comorbidity
Hemoglobins
Quality of Life
Veterans Hospitals
Gastrointestinal Neoplasms
African Americans
Blood Glucose
Life Style
Lung Neoplasms
Analysis of Variance
Breast
Nursing
Outpatients
Demography
Glucose

Keywords

  • Breast cancer
  • Chemotherapy
  • Gastrointestinal cancer
  • Glycosylated hemoglobin A1c
  • Gynecologic cancer
  • Lung cancer
  • Symptom severity

ASJC Scopus subject areas

  • Oncology(nursing)

Cite this

Glycosylated hemoglobin A1c and lack of association with symptom severity in patients undergoing chemotherapy for solid tumors. / Hammer, Marilyn; Aouizerat, Bradley; Schmidt, Brian; Cartwright, Frances; Wright, Fay; Miaskowski, Christine.

In: Oncology Nursing Forum, Vol. 42, No. 6, 01.11.2015, p. 581-590.

Research output: Contribution to journalArticle

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abstract = "Purpose/Objectives: To assess the effects of high blood sugar at the levels of diabetic or prediabetic states during cancer treatment because patients undergoing chemotherapy (CTX) experience multiple symptoms that vary among individuals and may be affected by glucose levels. Design: Descriptive, cross-sectional. Setting: Two comprehensive cancer centers, one Veterans Affairs hospital, and four community-based oncology programs. Sample: 244 outpatients with breast, gastrointestinal, gynecologic, and lung cancers. Methods: Patients completed demographic and symptom questionnaires. Glycosylated hemoglobin A1c (HbA1c) was evaluated to determine diabetic state. Descriptive statistics and one-way analyses of variance were used in the analyses. Main Research Variables: HbA1c, symptom severity scores, patient and clinical characteristics (e.g., age, gender, comorbidities, sociodemographic information, body mass index [BMI], lifestyle factors). Findings: HbA1c results showed 9{\%} of the sample in the diabetic and 26{\%} in the prediabetic state. Patients in the diabetic state reported a higher number of comorbid conditions and were more likely to be African American. Patients in the prediabetic state were older aged. Patients in the diabetic and prediabetic states had a higher BMI compared to nondiabetic patients. No differences in symptom severity or quality-of-life (QOL) scores were found among the three diabetic states. Conclusions: This study is the first to evaluate for associations between diabetic states and symptom severity and QOL scores in patients receiving CTX. This study confirmed that older age, as well as having higher BMI and having multiple comorbidities, were associated with increased mean glycemic levels. Implications for Nursing: Clinicians should assess and identify patients with diabetes or prediabetes undergoing treatment for cancer. Patients who are older aged, those with a high BMI, and those with multiple comorbid conditions may be at increased risk for higher glycemic states.",
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AU - Miaskowski, Christine

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AB - Purpose/Objectives: To assess the effects of high blood sugar at the levels of diabetic or prediabetic states during cancer treatment because patients undergoing chemotherapy (CTX) experience multiple symptoms that vary among individuals and may be affected by glucose levels. Design: Descriptive, cross-sectional. Setting: Two comprehensive cancer centers, one Veterans Affairs hospital, and four community-based oncology programs. Sample: 244 outpatients with breast, gastrointestinal, gynecologic, and lung cancers. Methods: Patients completed demographic and symptom questionnaires. Glycosylated hemoglobin A1c (HbA1c) was evaluated to determine diabetic state. Descriptive statistics and one-way analyses of variance were used in the analyses. Main Research Variables: HbA1c, symptom severity scores, patient and clinical characteristics (e.g., age, gender, comorbidities, sociodemographic information, body mass index [BMI], lifestyle factors). Findings: HbA1c results showed 9% of the sample in the diabetic and 26% in the prediabetic state. Patients in the diabetic state reported a higher number of comorbid conditions and were more likely to be African American. Patients in the prediabetic state were older aged. Patients in the diabetic and prediabetic states had a higher BMI compared to nondiabetic patients. No differences in symptom severity or quality-of-life (QOL) scores were found among the three diabetic states. Conclusions: This study is the first to evaluate for associations between diabetic states and symptom severity and QOL scores in patients receiving CTX. This study confirmed that older age, as well as having higher BMI and having multiple comorbidities, were associated with increased mean glycemic levels. Implications for Nursing: Clinicians should assess and identify patients with diabetes or prediabetes undergoing treatment for cancer. Patients who are older aged, those with a high BMI, and those with multiple comorbid conditions may be at increased risk for higher glycemic states.

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KW - Lung cancer

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