From the Guidelines
Yes, cancer can cause hyperglycemia (high blood sugar) due to various mechanisms, including insulin resistance, increased glucose consumption by cancer cells, and release of inflammatory cytokines that interfere with normal insulin signaling, as supported by the most recent study 1.
Mechanisms of Hyperglycemia in Cancer
- Insulin resistance: Cancer cells can lead to insulin resistance, making it difficult for glucose to enter cells, resulting in high blood sugar levels 2, 3.
- Increased glucose consumption: Cancer cells consume large amounts of glucose for energy, which can lead to elevated blood glucose levels 2, 3.
- Inflammatory cytokines: Many cancers release inflammatory cytokines that interfere with normal insulin signaling, contributing to hyperglycemia 2, 3.
- Cancer treatments: Certain cancer treatments, such as corticosteroids like prednisone or dexamethasone, can cause hyperglycemia as a side effect 1.
Importance of Managing Hyperglycemia in Cancer Patients
- Regular blood glucose monitoring: Patients with cancer who develop new-onset hyperglycemia should have their blood glucose monitored regularly 1.
- Treatment with insulin or oral diabetes medications: Depending on the severity, patients may require insulin or oral diabetes medications to manage their blood sugar levels 1.
- Impact on outcomes and quality of life: Managing blood sugar is important during cancer treatment as hyperglycemia can worsen outcomes and quality of life 1.
From the FDA Drug Label
Changes in an insulin regimen (e.g., insulin strength, manufacturer, type, injection site or method of administration) may affect glycemic control and predispose to hypoglycemia [see Warnings and Precautions (5. 3)] or hyperglycemia. Hyperglycemia has been reported with repeated insulin injections into areas of localized cutaneous amyloidosis; hypoglycemia has been reported with a sudden change to an unaffected injection site.
The FDA drug label does not directly answer the question of whether cancer can cause hyperglycemia. The information provided is related to insulin therapy and its effects on glycemic control, but it does not mention cancer as a cause of hyperglycemia 4, 5.
From the Research
Hyperglycemia and Cancer
- Hyperglycemia is a common condition in patients undergoing cancer treatment, which can impact treatment and outcomes, increasing the risk of complications and worsening health-related quality of life (HRQoL) 6.
- Cancer treatment can cause hyperglycemia, either as a new-onset condition or as an exacerbation of existing diabetes, and hyperglycemia related to oncology treatment can have unusual causes and challenges in management 6.
- Hyperglycemia can increase the risk for adverse events and outcomes in patients undergoing treatment for cancer, and understanding the contributors to and consequences of hyperglycemia can guide the development of screening tools to predict which individuals are at the greatest risk for hyperglycemic episodes prior to starting cancer therapies 7.
Mechanisms and Outcomes
- Hyperglycemia and the imbalance of hormones are factors that contribute to the molecular link between diabetes mellitus and carcinogenesis and cancer progression, and hyperglycemia alone or in combination with hyperinsulinemia are key factors that promote cancer aggressiveness 8.
- High glucose levels play an important role in cancer, and a high glycaemic index, glycaemic load diet, high sugar intake, high blood glucose, and diabetes mellitus all increase the risk of cancer 9.
- Various signals are involved in high glucose-induced tumorigenesis, cancer proliferation, apoptosis, invasion, and multidrug resistance, and reactive oxygen species might be important targets in cancer progression that are induced by high glucose levels 9.
Diabetes Mellitus and Cancer Risk
- Type 2 diabetes mellitus has been associated with an increased risk of hepatic, pancreatic, colon, endometrial, breast, and bladder cancer, although a mechanism of action for the increased risk has not been completely elucidated in the medical literature 10.
- The use of specific antidiabetic drugs, such as metformin, has been shown to possibly decrease the rate of specific cancers when used in the treatment of type 2 diabetes, while the use of insulin analogs, such as glargine, has been associated with an increased risk of cancer 10.