scholarly journals Improvement of Diabetes Mellitus After Colorectal Cancer Surgery: A Retrospective Study of Predictive Factors For Type 2 Diabetes Mellitus Remission and Overall Survival

2021 ◽  
Vol 11 ◽  
Author(s):  
Dong Peng ◽  
Xiao-Yu Liu ◽  
Yu-Xi Cheng ◽  
Wei Tao ◽  
Yong Cheng
Keyword(s):  
Diabetes Mellitus ◽  
Colorectal Cancer ◽  
Type 2 Diabetes ◽  
Overall Survival ◽  
Weight Loss ◽  
Type 2 Diabetes Mellitus ◽  
Regression Analysis ◽  
Predictive Factors ◽  
Odds Ratio

PurposeThe purpose of the current study was to evaluate the impact of colorectal cancer (CRC) surgery on type 2 diabetes mellitus (T2DM) and to analyze the change in T2DM on overall survival after CRC surgery.MethodsPatients who underwent CRC surgery were retrospectively enrolled from January 2013 to December 2019. The status of T2DM pre- and 1-year after CRC surgery was recorded, and predictive factors for T2DM remission and overall survival were analyzed.ResultsA total of 296 patients were included in this study. Thirty-eight patients experienced remission of T2DM 1 year after CRC surgery, and the remission rate was 12.8%. Weight loss was significantly higher in the T2DM remission group (p = 0.038), and the T2DM duration was significantly shorter in the T2DM remission group (p = 0.015). In the multivariate logistic regression analysis, higher weight loss (p = 0.046, odds ratio = 1.060, 95% CI = 1.001–1.122) and shorter T2DM duration (p = 0.019, odds ratio = 1007, 95% CI = 1.001–1.014) were predictive factors for remission of T2DM. Furthermore, in multivariate Cox regression analysis, lower TNM stage (p = 0.000, odds ratio = 2.147, 95% CI = 1.474–3.128) and T2DM remission (p = 0.033, odds ratio = 2.999, 95% CI = 1.091–8.243) were the predictive factors for better overall survival.ConclusionPatients with concurrent CRC and T2DM had a 12.8% remission 1 year after CRC surgery. Higher weight loss and shorter T2DM duration contributed to T2DM remission, and patients with T2DM remission could improve in terms of their overall survival.

scholarly journals P-82 Impact of type 2 diabetes mellitus in overall survival and clinical features of Latin patients with colorectal cancer: A 15-year follow-up

2021 ◽  
Vol 32 ◽  
pp. S125-S126
Author(s):  
G. Calderillo-Ruiz ◽  
C. Diaz ◽  
H. Lopez Basave ◽  
E. Ruiz-Garcia ◽  
A. Apodaca ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Colorectal Cancer ◽  
Type 2 Diabetes ◽  
Overall Survival ◽  
Type 2 Diabetes Mellitus ◽  
Clinical Features

Less Advanced Stages of Colon Cancer in Patients with Type 2 Diabetes Mellitus: an Unexpected Finding?

2012 ◽  
Vol 120 (04) ◽  
pp. 224-228 ◽  
Author(s):  
J. Nagel ◽  
S. Bücker ◽  
M. Wood ◽  
R. Stark ◽  
B. Göke ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Colorectal Cancer ◽  
Type 2 Diabetes ◽  
Colon Cancer ◽  
Type 2 Diabetes Mellitus ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Lower Risk ◽  
Advanced Stages

AbstractEpidemiological studies have found an increased risk for colon cancer and faster disease progression in patients with type 2 diabetes mellitus (T2DM). We aimed to determine whether patients with T2DM are diagnosed with more advanced stages of colorectal cancer, i. e., metastasized disease (UICC III and IV), at the time of diagnosis, since such a finding may have an impact on future guidelines for patients with T2DM.A cross-sectional analysis of colorectal cancer patients was performed. Stages at diagnosis in patients with (18.0%) or without (82%) T2DM were compared using logistic regression analysis to correct for confounders.Patients with T2DM were older, more obese, and more often male (each p<0.05). Unexpectedly, patients with T2DM had a lower risk for metastasized disease at diagnosis (p=0.023). Correction for age, gender, BMI, smoking and aspirin intake in a multiple logistic regression analysis did not change the result (OR=0.57, p=0.037). When looking at individual cancer stages rather than collapsed categories, there was a trend for less advanced stages in patients with T2DM (p=0.093). Excluding stage I because of potential screening bias due to the introduction of (insurance-covered) colonoscopy screening improved model fit, and confirmed less advanced cancer stages (p=0.0246).Possibly because of earlier detection, patients with T2DM may be at lower risk for advanced stages of colon cancer at diagnosis. Further studies are warranted to confirm our results and to investigate the impact of closer medical surveillance in patients with type 2 diabetes mellitus.

TYPE 2 DIABETES MELLITUS REMISSION AND ITS PREDICTION AFTER TWO-STAGE SURGICAL TREATMENT OF PATIENTS WITH MORBID OBESITY

2019 ◽  
Vol 72 (5) ◽  
pp. 739-743
Author(s):  
Oleksandr Yu. Ioffe ◽  
Mykola S. Kryvopustov ◽  
Yuri A. Dibrova ◽  
Yuri P. Tsiura
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Morbid Obesity ◽  
Weight Loss ◽  
Type 2 Diabetes Mellitus ◽  
Surgical Treatment ◽  
Two Stage ◽  
C Peptide ◽  
Peptide Level

Introduction: Morbid obesity (MO) has a significant impact on mortality, health and quality of life of patients. Type 2 diabetes mellitus (T2DM) is a common comorbidity in patients with MO. The aim is to study T2DM remission and to develop a prediction model for T2DM remission after two-stage surgical treatment of patients with MO. Materials and methods: The study included 97 patients with MO. The mean BMI was 68.08 (95% CI: 66.45 - 69.71) kg/m2. 70 (72,2%) patients with MO were diagnosed with T2DM. The first stage of treatment for the main group (n=60) included the IGB placement, for the control group (n=37) - conservative therapy. In the second stage of treatment the patients underwent bariatric surgery. The study addresses such indicators as BMI, percentage of weight loss, percentage of excess weight loss, ASA physical status class, fasting glucose level, HbA1c, C-peptide. Results: Two-stage treatment of morbidly obese patients with T2DM promotes complete T2DM remission in 68.1% of patients. The risk prediction model for failure to achieve complete T2DM remission 12 months after LRYGB based on a baseline C-peptide level has a high predictive value, AUC = 0.84 (95% CI: 0.69-0.93), OR = 0.23 ( 95% CI: 0.08-0.67). Conclusions: Two-stage treatment of patients with MO promotes improvement of carbohydrate metabolism indicators. With a C-peptide level > 3.7 ng/ml, prediction of complete T2DM remission 12 months after Laparoscopic Roux-en-Y Gastric Bypass is favorable.

115 RISK OF POST-COLONOSCOPY COLORECTAL CANCER IN PATIENTS WITH TYPE 2 DIABETES MELLITUS: A DANISH POPULATION-BASED COHORT STUDY

2021 ◽  
Vol 160 (6) ◽  
pp. S-30
Author(s):  
Frederikke Sch⊘nfeldt Troelsen ◽  
Henrik Toft S⊘rensen ◽  
Lars Pedersen ◽  
Rune Erichsen
Keyword(s):  
Diabetes Mellitus ◽  
Colorectal Cancer ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cohort Study ◽  
Population Based ◽  
Danish Population

scholarly journals Incretin-Based Therapies in Type 2 Diabetes Mellitus

2008 ◽  
Vol 93 (10) ◽  
pp. 3703-3716 ◽  
Author(s):  
Chee W. Chia ◽  
Josephine M. Egan
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Weight Loss ◽  
Type 2 Diabetes Mellitus ◽  
Evidence Synthesis ◽  
Glycosylated Hemoglobin ◽  
Cell Mass ◽  
New Drugs ◽  
Medline Search

Context: Glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide are incretins secreted from enteroendocrine cells postprandially in part to regulate glucose homeostasis. Dysregulation of these hormones is evident in type 2 diabetes mellitus (T2DM). Two new drugs, exenatide (GLP-1 mimetic) and sitagliptin [dipeptidyl peptidase (DPP) 4 inhibitor], have been approved by regulatory agencies for treating T2DM. Liraglutide (GLP-1 mimetic) and vildagliptin (DPP 4 inhibitor) are expected to arrive on the market soon. Evidence Acquisition: The background of incretin-based therapy and selected clinical trials of these four drugs are reviewed. A MEDLINE search was conducted for published articles using the key words incretin, glucose-dependent insulinotropic polypeptide, GLP-1, exendin-4, exenatide, DPP 4, liraglutide, sitagliptin, and vildagliptin. Evidence Synthesis: Exenatide and liraglutide are injection based. Three-year follow-up data on exenatide showed a sustained weight loss and glycosylated hemoglobin (HbA1c) reduction of 1%. Nausea and vomiting are common. Results from phase 3 studies are pending on liraglutide. Sitagliptin and vildagliptin are orally active. In 24-wk studies, sitagliptin reduces HbA1c by 0.6–0.8% as monotherapy, 1.8% as initial combination therapy with metformin, and 0.7% as add-on therapy to metformin. Vildagliptin monotherapy lowered HbA1c by 1.0–1.4% after 24 wk. Their major side effects are urinary tract and nasopharyngeal infections and headaches. Exenatide and liraglutide cause weight loss, whereas sitagliptin and vildagliptin do not. Conclusions: The availability of GLP-1 mimetics and DPP 4 inhibitors has increased our armamentarium for treating T2DM. Unresolved issues such as the effects of GLP-1 mimetics and DPP 4 inhibitors on β-cell mass, the mechanism by which GLP-1 mimetics lowers glucagon levels, and exactly how DPP 4 inhibitors lead to a decline in plasma glucose levels without an increase in insulin secretion, need further research.

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