Managing people with diabetes during the cancer palliation in the era of simultaneous care

Published:December 18, 2017DOI:https://doi.org/10.1016/j.diabres.2017.12.010

      Highlights

      • Diabetes, cancer, treatment toxicity together act as a Bermuda Triangle with regard to predicting outcomes, disability, places of care and where/how to die.
      • Both palliative care and life prolonging care must be provided through out the disease course: simultaneous care modality.
      • Simultaneous care is the emerging framework to properly address complex and changeable needs.
      • Pain management requires a careful balance concerning all the clinical elements involved.

      Abstract

      Managing people with diabetes and cancer during palliation constitutes a daunting challenge. Cancer, diabetes and treatment toxicity could be seen as a “Bermuda Triangle” for physician and health care professionals in general. Based on literature review, the present paper stresses the distinctive aspects that diabetes and cancer together involve and bring out. Considering the simultaneous care approach as the basement of our perspective, we explore the areas of palliative intervention for which the specific features of persons with diabetes and cancer emerge: pain manifestation and treatment, response to opioids, psychosocial and communication aspects, infection-related susceptibility and complications.
      The overall impact of suffering that these two diseases in association involve requires new awareness and a cultural attitude towards new network based approaches in order to strengthen the person-centered health care in this field.

      Keywords

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      References

        • Waller A.
        • Dodd N.
        • Tattersal M.H.N.
        • Nair B.
        • Sanso-Fisher R.
        Improving hospital based end of life care processes and outcomes: a systematic review of research output, quality and effectiveness.
        BMC Palliative Care. 2017; 16: 34
        • Krug E.G.
        Trends in diabetes: sounding the alarm.
        Lancet. 2016; 387: 1485-1486
        • Giovannucci E.
        • Harlan D.M.
        • Archer M.C.
        • Bergenstal R.M.
        • Gapstur S.M.
        • Habel L.A.
        • Pollak M.
        • Regensteiner J.G.
        • Yee D.
        Diabetes and cancer: a consensus report.
        Diabetes Care. 2010; 33: 1674-1685
        • Moslehi J.J.
        Cardiovascular toxic effects of targeted cancer therapies.
        N Engl J Med. 2016; 375: 1457-1467
        • Dionisio R.
        • Giardini A.
        • De Cata P.
        • Pirali B.
        • Rossi S.
        • Negri E.M.
        • et al.
        Diabetes management in end of life: a preliminary report stemming from clinical experience.
        Am J Hosp Palliat Care. 2015 Sep; 32: 588-593
        • Johnston G.M.
        • Lethbridge L.
        • Talbot P.
        • Dunbar M.
        • Jewell L.
        • Henderson D.
        • et al.
        Identifying persons with diabetes who could benefit from a palliative care approach to care.
        Can J Diabetes. 2015; 39: 29-35
        • Ranc K.
        • Jorgensen M.E.
        • Friis S.
        • Carstensen B.
        Mortality after cancer among patients with diabetes mellitus: effect of diabetes duration and treatment.
        Diabetologia. 2014; 57: 927-934
        • Currie C.J.
        • Poole C.D.
        • Jenkins-Jones S.
        • Gale E.A.M.
        • Johnson J.A.
        • Morgan C.L.
        Mortality after incident cancer in people with and without type 2 diabetes.
        Diabetes Care. 2012; 35: 299-304
        • Lipscombe L.L.
        • Goodwin P.J.
        • Zinman B.
        • McLaughlin J.R.
        • Hux J.E.
        The impact of diabetes on survival following breast cancer.
        Breast Cancer Res Treat. 2008; 109: 389-395
        • Barone B.B.
        • Yeh H.C.
        • Snyder C.F.
        • Peairs K.S.
        • Stein K.B.
        • Derr R.L.
        • et al.
        Long-term all_cause mortality in cancer patients with preexisting diabetes mellitus: a systematic review and meta-analysis.
        JAMA. 2008; 300: 2754-2764
        • Vissers P.A.J.
        • Falzon L.
        • van de Poll-Franse L.
        • Pouwer F.
        • Thong M.S.Y.
        The impact of having both cancer and diabetes on patient-reported outcomes: a systematic review and directions for future research.
        J Cancer Surviv. 2016; 10: 406-415
        • Gunn K.L.
        • Seers K.
        • Posner N.
        • Coates V.
        Somebody there to watch over you: the role of the family in everyday and emergency diabetes care.
        Health Soc Care Community. 2012; 20: 591-598
        • Ji J.
        • Zoller B.
        • Sundquist K.
        • Sundquist J.
        Increased risks of coronary heart disease and stroke among spousal caregivers of cancer patients.
        Circulation. 2012; 125: 1742-1747
        • Berlits C.
        The Bermuda Triangle.
        Doubleday & Company, Inc, 1974
        • Teno J.M.
        • Gozalo P.L.
        • Bynum J.P.
        • Leland N.E.
        • Miller S.C.
        • Morden N.E.
        • et al.
        Change in end of life care for Medicare beneficiaries: site of death, place of care, and health care transitions in 2000, 2005, and 2009.
        JAMA. 2013; 309: 470-477
        • Lu F.P.
        • Lin K.P.
        • Kuo H.K.
        Diabetes and the risk of multi-system aging phenotypes: a systematic review and meta-analysis.
        PLoS One. 2009; 4: e4144
      1. Munshi M. Managing the geriatric syndrome in patients with type 2 diabetes. Consult Pharm 2008; 23 (Suppl. B): 12–6.

        • Kirkman M.S.
        • Briscoe V.J.
        • Clark N.
        • Florez H.
        • Haas L.B.
        • Halter J.B.
        • et al.
        Diabetes in older adults.
        Diabetes Care. 2012; 35: 2650-2664
        • Pop-Busui R.
        • Boulton A.J.
        • Feldman E.L.
        • Bril V.
        • Freeman R.
        • Malik R.A.
        • et al.
        Diabetic neuropathy: a position statement by the American Diabetes Association.
        Diabetes Care. 2017; 40: 136-154
        • Kerckhove N.
        • Collin A.
        • Condè S.
        • Chaleteix C.
        • Pezet D.
        • Balayssac
        Long term effects, pathophysiological mechanism, and risk factors of chemotherapy-induced peripheral neuropathies: a comprehensive literature review.
        Front Pharmacol. 2017; 8: 86
        • Balayssac D.
        • Feerier J.
        • Descoeur J.
        • Ling B.
        • Pezet D.
        • Eschalier A.
        • et al.
        Chemotherapy-induced peripheral neuropathies: from clinical relevance to preclinical evidence.
        Expert Opin Drug Saf. 2011; 10: 407-417
        • Argyriou A.A.
        • Bruna J.
        • Marmiroli P.
        • Cavaletti G.
        Chemotherapy-induced peripheral neurotoxicity (CIPN): an update.
        Crit Rev Oncol Hematol. 2012; 82: 51.77
        • Hong J.S.
        • Tian J.
        • Wu L.H.
        The influence of chemotherapy-induced neurotoxicity on psychological distress and sleep disturbance in cancer patients.
        Curr Oncol. 2014; 21: 174-180
        • Hershman D.L.
        • Lacchetti C.
        • Dworkin R.H.
        • Lavoie Smith E.M.
        • Bleeker J.
        • Cavaletti G.
        • Chauhan C.
        • Gavin P.
        • Lavino A.
        • Lustberg M.B.
        • Paice J.
        • Schneider B.
        • Smith T.
        • Terstriep S.
        • Wagner-Johnston N.
        • Bak K.
        • Loprinzi C.L.
        American Society of Clinical Oncology.
        J Clin Oncol. 2014; 32: 1941-1967
        • Cavaletti G.
        • Zanna C.
        Current status and future prospects for the treatment of chemotherapy-induced peripheral neurotoxicity.
        Eur J Cancer. 2002; 38: 1832-1837
        • Visser P.A.
        • Mols F.
        • Thong M.S.
        • Pouwer F.
        • Vreugdenhil G.
        • van de Poll-Franse L.V.
        The impact of diabetes on neuropathic symptoms and receipt of chemotherapy among colorectal cancer patients: results from the PROFILES registry.
        J Cancer Surviv. 2015; 9: 523-531
        • Vigo D.
        • Thornicroft G.
        • Atun R.
        Estimating the true global burden of mental illness.
        Lancet Psychiatry. 2016; 3: 171-178
        • Macdonald G.C.
        • Campbell L.V.
        Mental illness: the forgotten burden on diabetes populations?.
        Lancet. 2016; 388: 561
        • Zhang X.
        • Norris S.L.
        • Gregg E.W.
        • Cheng Y.J.
        • Beckles G.
        • Kahn H.S.
        Depressive symptoms and mortality among persons with and without diabetes.
        Am J Epidemiol. 2005; 161: 652-660
        • Ferrel B.R.
        • Temel J.S.
        • Temin S.
        • Alesi E.R.
        • Baldoni T.A.
        • Basch E.M.
        • et al.
        Integration of palliative care into standard oncology care: American Society of Clinical Oncology Clinical practice guideline update.
        J Clin Oncol. 2017; 35: 96-112
        • Cherny N.
        • Catane R.
        • Schrijvers D.
        • Kloke M.
        • Strasser F.
        European Society for Medical Oncology (ESMO) Program for the integration of oncology and Palliative Care: a 5-year review of the designated centers’incentive program.
        Ann Oncol. 2010; 21: 362-369
        • Hui D.
        • Kim Y.J.
        • Park J.C.
        • Zhang Y.
        • Strasser F.
        • Cherny N.
        • et al.
        Integration of oncology and palliative care: a systematic review.
        Oncologist. 2015; 20: 77-83
        • Zagonel V.
        • Franciosi V.
        • Brunello A.
        • Biasco G.
        • Broglia C.
        • Cattaneo D.
        • Cavanna L.
        • Corsi D.
        • Farina G.
        • Fioretto L.
        • Gamucci T.
        • Lanzetta G.
        • Magarotto R.
        • Maltoni M.
        • Marchetti P.
        • Massa E.
        • Mastromauro C.
        • Melotti B.
        • Meriggi F.
        • Nacci A.
        • Pavese I.
        • Piva E.
        • Quirino M.
        • Roselli M.
        • Sacco C.
        • Tonini G.
        • Trentin L.
        • Ucci G.
        • Labianca R.
        • Gori S.
        • Pinto C.
        • Cascinu S.
        AIOM Simultaneous Care (SCC), task Force: ESMO Italian DCs. Position paper of the Italian Association of Medical Oncology on early palliative care in oncology practice (Simultaneous Care).
        Tumori. 2017; 103: 9-14
        • Temel J.S.
        • Greer J.A.
        • Muzikansky A.
        • Gallagher E.R.
        • Admane S.
        • Jacson V.A.
        • et al.
        Early palliative care for patients with metastatic non-small cell lung cancer.
        N Eng J Med. 2010; 363: 733-742
        • Hui D.
        • Bruera E.
        Supportive and palliative oncology – a new paradigm for comprehensive cancer care.
        Oncol Hematol Rev. 2013; 9: 68-74
        • Peppercorn J.M.
        • Smith T.J.
        • Helft P.R.
        • Debono D.J.
        • Berry S.R.
        • Wollins D.S.
        • et al.
        American Society of Clinical Oncology statement: toward individualized care for patients with advanced cancer.
        J Clin Oncol. 2011 Feb 20; 29: 755-760
        • Zimmermann C.
        • Swami N.
        • Krzyzanowska M.
        • Hannon B.
        • Leighl N.
        • Oza A.
        • et al.
        Early palliative care for patients with advanced cancer: a cluster randomised controlled trial.
        Lancet. 2014; 383: 1721-1730
        • Kaasa S.
        • Knudsen A.K.
        • Lundeby T.
        • Loge J.H.
        Integration between oncology and palliative care: a plan for the next decade?.
        Tumori. 2017; 103: 1-8
      2. Ramchandran K, Von Roenn JH. Palliative care always. Oncology (Williston Park) 2013; 27(1)13–6, 27–30, 32–4 passim.

        • Schnipper L.E.
        • Smith T.J.
        • Raghavan D.
        • Blayney D.W.
        • Ganz P.A.
        • Mulvey T.M.
        • et al.
        American Society of Clinical Oncology identifies five key opportunities to improve care and reduce costs: the top five list for oncology.
        J Clin Oncol. 2012; 30: 1715-1724
        • Hui D.
        • Kim S.H.
        • Roquemore J.
        • Dev R.
        • Chisholm G.
        • Bruera E.
        Impact of timing and setting of palliative care referral on quality of end of life care in cancer patients.
        Cancer. 2014; 120: 1743-1749
        • Parikh R.B.
        • Kirch R.A.
        • Smith T.J.
        • Temel J.S.
        Early specialty palliative care – translating data in oncology into practice.
        N Engl J Med. 2013; 369: 2347-2351
        • Obermeyer Z.
        • Makar M.
        • Abujaber S.
        • Dominici F.
        • Block S.
        • Cutler D.M.
        Association between the Medicare hospice benefit and health care utilization and costs for patients with poor-prognosis cancer.
        JAMA. 2014; 312: 1888-1896
        • Teno J.M.
        • Gozalo P.L.
        • et al.
        Quality and costs of end of life care.
        The need for transparency and accountability JAMA. 2014; 312: 1868-1869
        • Hui D.
        • Elsayem A.
        • De la Cruz M.
        • Berger A.
        • Zhukovsky D.S.
        • Palla S.
        • et al.
        Availability and integration of palliative care in US cancer centers.
        JAMA. 2010; 303: 1054-1061
        • Bruera E.
        • Hui D.
        Integrating supportive and palliative care in the trajectory of cancer: establishing goals and models of care.
        J Clin Oncol. 2010; 28: 4013-4017
        • Temel J.S.
        • Greer J.A.
        • El-Jawahri A.
        • Pirl W.F.
        • Park E.R.
        • Jackson V.A.
        • et al.
        Effects of early integrated palliative care in patients with lung cancer and gastrointestinal cancer: a randomized clinical trial.
        J Clin Oncol. 2017; 35: 834-841
        • Roeland E.J.
        Tailoring Palliative Care to the changing needs of people facing cancer.
        J Clin Oncol. 2017; 35: 813-815
        • Gallo M.
        • Gentile L.
        • Arvat E.
        • Bertetto O.
        • Clemente G.
        Diabetology and oncology meet in a network model: union is strength.
        Acta Diabetol. 2016; 53: 4
        • Van Den Beuken-van Everdingen M.H.
        • de Rijke J.M.
        • Kessels A.G.
        • Schouten H.C.
        • van Kleef M.
        • Patijn J.
        Prevalence of pain in patient with cancer: a systematic review of the past 40 years.
        Ann. Oncol. 2007; 18: 1437-1449
        • Abbott C.A.
        • Malik R.A.
        • van Ross E.R.
        • Kulkarni J.
        • Boulton A.J.
        Prevalence and characteristics of painful diabetic neuropathy in a large community- based diabetic population in the U.K..
        Diabetes Care. 2011; 34: 2220-2224
        • Colloca L.
        • Ludman T.
        • Bouhassira D.
        • Baron R.
        • Dickenson A.H.
        • Yarnitsky D.
        • et al.
        Neuropathic pain.
        Nat Rev Dis Primers. 2017; 16: 17002
        • Freeman R.
        Not all neuropathy in diabetes is of diabetic etiology: differential diagnosis of diabetic neuropathy.
        Curr Diab Rep. 2009; 9: 423-431
        • Duarte R.
        • Andronis L.
        • Lenders M.
        Quality of life increases in patients with painful diabetic neuropathy following treatment with spinal cord stimulation.
        Qual Life Res. 2016; 25: 1771-1777
        • De Vos C.
        • Meier K.
        • Zaalberg P.B.
        • et al.
        Spinal cord stimulation in patients with painful diabetic neuropathy: a multicentre randomized clinical trial.
        Pain. 2014; 155: 2426-2431
        • Smith H.
        • Bruckenthal P.
        Implication of opioid analgesia for medically complicated patients.
        Drugs Aging. 2010; 27: 417-433
        • Caraceni A.
        • Hanks G.
        • et al.
        Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the European Association for Palliative Care (EAPC).
        Lancet Oncol. 2012; 13: e58-68
        • Abu-Ashour W.
        • Twells L.
        • Valcour J.
        • Randell A.
        • Donnan J.
        • Howse P.
        • Gamble J.M.
        The association between diabetes mellitus and incident infections: a systematic review and meta-analysis of observational studies.
        BMJ Open Diabetes Res Care. 2017; 5 (doi: 10.1136 / bmjdrc-2016-000336. e.collection2017): e000336
        • Luk A.O.Y.
        • Lau E.S.H.
        • Cheung K.K.T.
        • Kong A.P.
        • Ma R.C.W.
        • Ozaki R.
        • Chow F.C.C.
        • So W.Y.
        • Chan J.C.N.
        Glycaemic control and risk of hospitalization for infection with patients with type 2 diabetes: Hong Kong Diabetes Registry.
        Diabetes Metab Res Rev. 2017; (doi: 10.1002/dmrr.2923)
        • Juthani-Mehta M.
        • Malani P.N.
        • Mitchell S.L
        Antimicrobials at the end of life, an opportunity to improve Palliative Care and Infection Management.
        JAMA. 2015; 314: 2017-2018
        • Levin P.D.
        • Simor A.E.
        • Moses A.E.
        Sprung CL End of life treatment and bacterial antibiotic resistance: a potential association.
        Chest. 2010; 138: 588-594
        • Hilliard M.E.
        • Powell P.W.
        • Anderson B.J.
        Evidence-based behavioral interventions to promote diabetes management in children, adolescents, and families.
        Am Psychol. 2016; 71: 590-601
        • Corathers S.D.
        • Mara C.A.
        • Chundi P.K.
        • Kichler J.C.
        Psychosocial patient-reported outcomes in pediatric and adolescent diabetes: a review and case example.
        Curr Diab Rep. 2017; 17: 45
        • Sinclair A.
        • Dunning T.
        • Rodriguez-Mañas L.
        Diabetes in older people: new insights and remaining challenges.
        Lancet Diabetes Endocrinol. 2015; 3: 275-285
        • Odgers-Jewell K.
        • Ball L.E.
        • Kelly J.T.
        • Isenring E.A.
        • Reidlinger D.P.
        • Thomas R.
        Effectiveness of group-based self-management education for individuals with Type 2 diabetes: a systematic review with meta-analyses and meta-regression.
        Diabet Med. 2017; 34: 1027-1039
        • Marengoni A.
        • Angleman S.
        • Melis R.
        • Mangialasche F.
        • Karp A.
        • Garmen A.
        • et al.
        Aging with multimorbidity: a systematic review of the literature.
        Ageing Res Rev. 2011; 10: 430-439
        • Sano M.
        • Zhu C.W.
        • Grossman H.
        • Schimming C.
        Longitudinal Cognitive Profiles in Diabetes: Results From the National Alzheimer's Coordinating Center's Uniform Data.
        J Am Geriatr Soc. 2017; https://doi.org/10.1111/jgs.15014. [Epub ahead of print
        • Young-Hyman D.
        • de Groot M.
        • Hill-Briggs F.
        • Gonzalez J.S.
        • Hood K.
        • Peyrot M.
        Psychosocial care for people with diabetes: a position statement of the American Diabetes Association.
        Diabetes Care. 2017; 40: 287
        • Sinclair A.J.
        • Armes D.G.
        • Randhawa G.
        • Bayer A.J.
        Caring for older adults with diabetes mellitus: characteristics of carers and their prime roles and responsibilities.
        Diabet Med. 2010; 27: 1055-1059
        • Kim S.H.
        • Lee A.
        Health-literacy-sensitive diabetes self-management interventions: a systematic review and meta-analysis.
        Worldviews Evid Based Nurs. 2016; 13: 324-333
        • Rosland A.M.
        • Heisler M.
        • Piette J.D.
        The impact of family behaviors and communication patterns on chronic illness outcomes: a systematic review.
        J Behav Med. 2012; 35: 221-239
        • Boyd K.
        • Murray S.A.
        Why is talking about dying such a challenge?.
        BMJ. 2014; 6: g3699
        • Dunning T.
        • Duggan N.
        • Savage S.
        Caring for people with diabetes at the end of life.
        Curr Diab Rep. 2016; 16: 103
        • Dikkers M.F.
        • Dunning T.
        • Savage S.
        Information needs of family carers of people with diabetes at the end of life: a literature review.
        J Palliat Med. 2013; 16: 1617-1623
        • Sanders J.
        Finding the right words at the right time–high-value advance care planning.
        N Engl J Med. 2015; 372: 598-599
      3. America Diabetes Association. Older adults. Sec 11. Standards of Medical Care in Diabetes-2017. Diabetes Care 2017;40(suppl.1):S99–S104.

      4. Diabetes UK. End of Life Diabetes Care Clinical Care Recommendations Second Edition October 2013. <https://www.diabetes.org.uk/professionals/position-statements-reports/diagnosis-ongoing-management-monitoring/end-of-life-care>, 2017 (accessed 01.10.2017).

        • Angelo M.
        • Ruchalski C.
        • Sproge B.J.
        An approach to diabetes mellitus in hospice and palliative medicine.
        J Palliat Med. 2011; 14: 83-87
      5. Gallo M, Muscogiuri G, Felicetti F, Faggiano A, Trimarchi F, Arvat E, Vigneri R, Colao A. Adverse glycaemic effects of cancer therapy: indications for a rational approach to cancer patients with diabetes. Metabolism 2017; pii: S0026–0495(17)30265–2.

        • Mazziotti G.
        • Gazzaruso C.
        • Giustina A.
        Diabetes in Cushing syndrome: basic and clinical aspects.
        Trends Endocrinol Metab. 2011; 22: 499-506
        • McCoubrie R.
        • Jeffrey D.
        • Paton C.
        • Dawes L.
        Managing diabetes mellitus in patients with advanced cancer: a case note audit and guidelines.
        Eur J Cancer Care. 2015; 14: 244-248
      6. <http://www.thewhpca.org/resources/item/definging-palliative-care>, 2017 (accessed 01.10.2017).

        • Hui D.
        • Bruera E.
        Integrating palliative care into the trajectory of cancer care.
        Nat Rev Clin Oncol. 2016; 13: 159-171