medwireNews: US researchers report a decrease in the use of key indicators of comprehensive diabetes care in the year following a cancer diagnosis among people with diabetes.
“This finding suggests that diabetes management may be deprioritized by patients and/or providers during the acute cancer treatment phase,” say lead author Laura Pinheiro and colleagues from Weill Cornell Medicine in New York.
Given the increased risk for infections, hospitalizations, and mortality in cancer patients with diabetes, the team believes that “[u]nderstanding and addressing the reasons for [the decline] may improve outcomes in this population.”
The study, which used data from the linked Surveillance, Epidemiology, and End Results–Medicare registry for 2007–2015, included 32,728 individuals aged at least 65 years with diabetes and nonmetastatic prostate, breast, or colorectal cancer who were matched to an equal number of people with diabetes on the basis of age, sex, comorbidities, and diabetes severity. Participants in the latter group were assigned a so-called pseudodiagnosis date based on the cancer diagnosis date of their matched counterparts.
Among patients with cancer, the rates of glycated hemoglobin (HbA1c) and low-density lipoprotein (LDL) tests decreased by 3.7 and 5.7 percentage points, respectively, in the 12 months before and 12 months after diagnosis. The corresponding decreases among control patients were 1.4 and 1.5 percentage points, where the between-group differences were statistically significant.
By contrast, the use of eye exams for diabetic retinopathy stayed stable pre- and postdiagnosis in both groups.
The findings were similar in an analysis using adjusted difference-in-differences models, again showing significantly greater, albeit modest, declines in the use of HbA1c and LDL tests from the year before diagnosis to the year after among individuals with cancer, report the study authors in Cancer.
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