Disturbances of serum glucose level regulation in patients with advanced neoplastic disease

Maciej Bączyk; Katarzyna Ziemnicka; Ewa Bączyk; Jacek Łuczak

Vol 1, No 2 (2002): Polish Palliative Medicine

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Published online: 2002-06-04

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Disturbances of serum glucose level regulation in patients with advanced neoplastic disease

Maciej Bączyk, Katarzyna Ziemnicka, Ewa Bączyk, Jacek Łuczak

Advances in Palliative Medicine 2002;1(2):49-56.

Vol 1, No 2 (2002): Polish Palliative Medicine

Artykuły poglądowe

Published online: 2002-06-04

Abstract

Disturbances of carbohydrate metabolism and frequent variations of serum glucose level in patients with advanced neoplastic disease are the critical clinical problem. Patients, admitted to the long term medical care units, who have glucose metabolism abnormalities can be divided into two groups: first — are the patients with symptomatic diabetes mellitus, and second — are the patients with periodic carbohydrate metabolism abnormalities without clinical manifestation of diabetes mellitus. These glucose metabolism abnormalities in patients with malignancy can be determined by such factors as: chronic excess of cortisol and katecholamines, and relative predominance of glucagons over insulin, that causes acceleration of lypolysis and glycogenolysis. Mechanism mentioned above lead independently also to marked increase in liver guconeogenesis in association with insulin resistance and disturbances in insuline secretion. Other factors, that may affect serum glucose level regulation, are the cytokines released in excess like TNF-a, IL-1 and interferon. Knowledge about diagnosis and treatment principles of glucose metabolism derangements based on understanding of mechanism that can lead to these disorders, should contribute to better care of this group of patients, thereby improve quality of their life.