题名

糖尿病病人於癌症末期的血糖處置

并列篇名

Glycemic Control of Diabetes in Terminal Cancer Patients

DOI

10.6537/TJHPC.201711_22(3).005

作者

林盈利(Ying-Li Lin)；林益卿(I-Ching Lin)；蔡佩渝(Pei-Yu Tsai)；余昭宏(Chao-Hung Yu)

关键词

糖尿病 ； 癌症末期 ； 緩和醫療照護 ； diabetes mellitus ； terminal illness ； palliative care

期刊名称

安寧療護雜誌

卷期/出版年月

22卷3期（2017 / 11 / 01）

页次

325 - 332

内容语文

繁體中文
中文摘要

糖尿病與癌症為全球性的重大健康議題，根據2016 年國人死因統計，癌症為十大死因之首，糖尿病則高居第五名，糖尿病可能增加罹癌的風險，也影響癌症治療效果與臨床預後，顯示血糖控制於正常值的重要性。然而癌症末期的糖尿病病人，其身體可能處在高胰島素抗性、反覆感染、食慾不振、噁心、嘔吐…等狀態，若嚴格控制血糖容易引發低血糖的風險。當病人接受緩和照護時，症狀控制的重要性遠大於治療血糖數值，整合醫療照護準則、醫療團隊評估與病人意願，給予病人個別化的治療。
英文摘要

Diabetes and cancer are major global health issues. Cancer remained to be the first leading cause of death in Taiwan in 2016, whereas diabetes was ranked to be the fifth leading cause of death. Patients with diabetes are at a high risk of developing cancer, have a worse response to cancer chemotherapy and have a poor prognosis. It is very important to maintain blood glucose at nearly normal levels. While diabetic patients in terminal illness may have marked insulin resistance, frequent infections, anorexia, nausea and vomiting, strict blood glucose control may increase the risk of hypoglycemia. In palliative care, the symptoms should be treated rather than the blood glucose values. As treatment guidelines adjusted according to patient preference and the views of medical staff, each patient can receive the individualized treatment.
主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
参考文献
  1. Berstein, L.M.(2010).Modern approach to metabolic rehabilitation of cancer patients: biguanides (phenformin and metformin) and beyond.Future Oncol,6,1313-1323.
  2. Diabetes UK(2013).Diabetes UK. End of Life Diabetes Care: Full Strategy Document. Second Edition October 2013..
  3. Ford-Dunn, S,Smith, A,Quin, J(2006).Management of diabetes during the last days of life: attitudes of consultant diabetologists and consultant palliative care physicians in the UK.Palliative Medicine,20,197-203.
  4. Gallagher, E.J.,LeRoith, D.(2010).Insulin, insulin resistance, obesity, and cancer.Curr. Diab. Rep,10,93-100.
  5. García-Jiménez, C,García-Martínez, JM,Chocarro-Calvo, A,Dela Vieja, A(2014).A new link between diabetes and cancer: enhanced WNT/β-catenin signaling by high glucose.J Mol Endocrinol,52,R51-R66.
  6. Giovannucci, E,Harlan, DM,Archer, MC(2010).Diabetes and cancer: a consensus report.CA Cancer J Clin,60,207-221.
  7. Glicksman, A.S.,Rawson R.W.(1956).Diabetes and altered carbohydrate metabolism in patients with cancer.Cancer,9,1127-1134.
  8. King, EJ,Haboubi, H,Evans, D,Baker, I,Bain, SC,Stephens, JW(2012).The management of diabetes in terminal illness related to cancer.QJM,105,3-9.
  9. Kondo, S,Kondo, M,Kondo, A(2013).Glycemia control using A1C level in terminal cancer patients with preexisting type 2 diabetes.J Palliat Med,16,790-793.
  10. McCoubrie, R,Jeffrey, D,Paton, C,Dawes, L(2005).Managing diabetes mellitus in patients with advanced cancer: a case note audit and guidelines.Eur J Cancer Care (Engl),14,244-248.
  11. Mercadante, S.,Fulfaro, F.,Casuccio, A(2001).The use of corticosteroids in home palliative care.Support Care Cancer,9,386-389.
  12. Poulson, J.(1997).The management of diabetes in patients with advanced cancer.J. Pain Symptom Manage,13,339-346.
  13. Quinn, K.,Hudson, P,Dunning, T(2006).Diabetes management in patients receiving palliative care.J. Pain Symptom Manage,32,275-286.
  14. Warren, RE,Deary, IJ,Frier, BM(2003).The symptoms of hyperglycaemia in people with insulin treated diabetes: classification using principal components analysis.Diabetes Metab Res Rev,19,408-414.
  15. Zylicz, Zbigniew(2010).Management of diabetes mellitus in terminally ill cancer patients.Adv. Pall. Med.,9(3),99-102.
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