Evaluation Of The Sociocultural Status and Management Course Of The Diabetic Patients Admitted To Internal Medicine Department of our Hospital Using SF36 Health Survey

Background: Cancer prevalence in diabetic patients in Bangladesh seems to be increasing as case detection of both diseases are far more than before. Till date no statistical data of diabetic patients with malignancy is available in Bangladesh. Treating both diabetes and malignancy in the same patient is challenging and sometimes requires multidisciplinary support. For such cases BIRDEM General Hospital offers supportive facilities including intensive care, chemotherapy, surgical intervention and oncology day care.Methods: This cross-sectional, observational study was carried out from January 2012 to June 2016 which included cancer patients irrespective of their diabetic status admitted in Internal Medicine Department of BIRDEM General Hospital. With prior informed consent of the patients, data were collected and statistical analysis was done using professional SPSS version 17.0 windows based program.Results: Total number of cancer patients was 114, whose diagnoses were confirmed by histopathological evidence (biopsy/FNAC), radiology reports and cancer markers, as appropriate. Among them 64 (56.1%) were male and 50 (43.9%) were female patients. Age of most of the patients was between 41-60 years (65, 57%). Mean age was 55.16 years in diabetic group and 44.47 years in non-diabetic group. Glycemic status revealed that most of the patients were diabetic (80, 70.2%). Among other co-morbid conditions, hypertension and ischemic heart disease were predominant (17 and 9 cases respectively). Prevalence of more than one comorbidites were marked in the diabetic group (33 cases, p value >0.001). Twenty one categories of malignancies were diagnosed during this study period. Majority of cases were lymphoma (21,18.4%), carcinoma breast (17,14.9%), carcinoma uterus and/or cervix (13,11.4%) and leukaemia (10,8.8%). Common clinical features included palpable lump (21,18.4%), lymphadenopathy (16,14%), anaemia (9,7.9%) and pain (8,7%). The number of patients presenting with multiple signs/symptoms were also significant (32,28.1%). Most patients were treated with chemotherapy (54,47.4%). Many cases warranted a combined approach (46,40.4%). Treatment response showed good response in 57(50%) cases. In 16 patients (14%) condition deteriorated and death occurred in 8 cases (7%). Even after repeated and empathic counseling we lost follow up of 15 cases (13.2%).Conclusion: The scenario becomes complicated when a diabetic patient develops malignancy and vice versa. Complications can arise from either spectrum of the diseases. Managing such cases are often challenging and require multi-disciplinary support. Management outcome of these cases so far in Internal Medicine Department, BIRDEM General Hospital shows a promising future.Birdem Med J 2016; 6(2): 107-111

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Socio-demographic characteristics and treatment outcome of patients with malignancy and type 2 diabetes

Bangladesh Journal of Medicine ◽

10.3329/bjmed.v28i2.33355 ◽

2018 ◽

Vol 28 (2) ◽

pp. 70-74

Author(s):

Md Raziur Rahman ◽

Samira Rahat Afroze ◽

Rene Suzan Claude Sarker ◽

Muhammad Abdur Rahim ◽

Khwaja Nazim Uddin

Keyword(s):

Internal Medicine ◽

Type 2 Diabetes ◽

General Hospital ◽

Response To Treatment ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Medicine Department ◽

Internal Medicine Department ◽

Radiology Reports

Background: In Bangladesh prevalence of malignancy in diabetic patients seems to be increasing as case detection of both diseases are far more than before. No statistical data of diabetic patients with malignancy is currently available in Bangladesh. Treatment of both diabetes and malignancy in the same patient is challenging for the physician and requires multidisciplinary support. For such cases BIRDEM General Hospital offers supportive facilities including intensive care, chemotherapy, surgical intervention and oncology day care.Methods : This is a cross-sectional observational study carried out from January 2011 to June 2016 which included adult diabetic patients with malignancy admitted in Internal Medicine Department of BIRDEM General Hospital. With prior informed consent of the patients, data were collected and statistical analysis was done using professional SPSS version 17.0 windows based program.Results : Total number of type 2 diabetic patients with malignancy was 80. Among them 49 (61.3%) were male and 31 (37.7%) were female patients. Almost two-third of the patients was between 41-60 years (63.8%). More than half of the patients belonged to urban settings (42, 52.5%) followed by sub-urban area (27, 33.7%). Smoking was the commonest (23.8%) among the risk factors. Family history for malignancy and exposure to occupational hazards were present in 11.3% and 7.5% cases respectively. Among co-morbid conditions, hypertension and ischemic heart disease were predominant. Twenty categories of malignancies were confirmed by histopathological evidence, radiology reports and cancer markers. The commonest malignancy in male and female was lymphoma and carcinoma breast respectively. Most patients were treated with chemotherapy (48.8%) and combined approach was required in 36.3% cases. Good response to treatment was observed in 46.3% cases, 15% patients deteriorated and death occurred in 6.3% cases.Conclusion : Type 2 diabetes and malignancy individually have their own consequences. When co-existing, patients require a holistic approach. Complications can arise from either spectrum of the diseases. If managed promptly and adequately, outcome of such cases is encouraging. Management outcome of these cases so far in Internal Medicine Department, BIRDEM General Hospital shows a promising future.Bangladesh J Medicine Jul 2017; 28(2) : 70-74

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