PDF(Pubmed)
Abstract：
BACKGROUND: Bladder cancer (BC) and Renal cell carcinoma (RCC) are the most common urogenital cancers among both sexes, with a yearly global incidence of around 500 000 each. Both BC and RCC have been linked to diabetes. Poor glycemic control (malglycemia) is a serious consequence of diabetes and a possible consequence of systemic treatments used in BC and RCC. The objective of this study was to investigate the prevalence of diabetes and use of hospital-based care for malglycemia in people with BC or RCC.
METHODS: This Swedish retrospective population-based register study used national health-data registers for longitudinal data on cancer incidence covering 15 years, use of hospital-based health care, and filled prescriptions of outpatient medications. Study endpoints included co-prevalence of diabetes in individuals with BC/RCC, healthcare resource utilization due to malglycemia, use of systemic corticosteroids, and changes in diabetes management for people with concomitant type 2 diabetes.
RESULTS: We identified 36,620 and 15,581 individuals diagnosed with BC and RCC, respectively, between 2006 and 2019. The proportion of individuals registered with diabetes was 24% in BC and 23% in RCC. An association between BC/RCC and poor glycemic control was found, although the number of malglycemic events in hospital-based care were few (65/59 per 1000 individuals with diabetes and BC/RCC respectively with at least one event). An earlier switch to insulin-based diabetes management was observed in BC/RCC compared to matched individuals with type 2 diabetes but no cancer. The results also indicated an association between steroid treatment and poor glycemic control, and that systemic corticosteroids were more common among people with BC/RCC compared to diabetes controls.
CONCLUSIONS: The high prevalence of diabetes and increased use of systemic corticosteroid treatment observed in this large national study highlights the need for specific clinical management, risk-assessment, and monitoring of individuals with BC/RCC and diabetes.
METHODS: This Swedish retrospective population-based register study used national health-data registers for longitudinal data on cancer incidence covering 15 years, use of hospital-based health care, and filled prescriptions of outpatient medications. Study endpoints included co-prevalence of diabetes in individuals with BC/RCC, healthcare resource utilization due to malglycemia, use of systemic corticosteroids, and changes in diabetes management for people with concomitant type 2 diabetes.
RESULTS: We identified 36,620 and 15,581 individuals diagnosed with BC and RCC, respectively, between 2006 and 2019. The proportion of individuals registered with diabetes was 24% in BC and 23% in RCC. An association between BC/RCC and poor glycemic control was found, although the number of malglycemic events in hospital-based care were few (65/59 per 1000 individuals with diabetes and BC/RCC respectively with at least one event). An earlier switch to insulin-based diabetes management was observed in BC/RCC compared to matched individuals with type 2 diabetes but no cancer. The results also indicated an association between steroid treatment and poor glycemic control, and that systemic corticosteroids were more common among people with BC/RCC compared to diabetes controls.
CONCLUSIONS: The high prevalence of diabetes and increased use of systemic corticosteroid treatment observed in this large national study highlights the need for specific clinical management, risk-assessment, and monitoring of individuals with BC/RCC and diabetes.
摘要：
背景：膀胱癌（BC）和肾细胞癌（RCC）是男女最常见的泌尿生殖道癌症，每年全球发病率约为50万。BC和RCC都与糖尿病有关。血糖控制不良(低血糖)是糖尿病的严重后果,也是BC和RCC中使用的全身治疗的可能后果。这项研究的目的是调查BC或RCC患者的糖尿病患病率和基于医院的血糖管理。
方法：这项瑞典基于人群的回顾性登记研究使用国家健康数据登记来获取15年癌症发病率的纵向数据，使用以医院为基础的医疗保健，并填写了门诊药物的处方。研究终点包括BC/RCC个体中糖尿病的共同患病率，由于血糖不良而导致的医疗保健资源利用，使用全身性皮质类固醇，以及合并2型糖尿病患者的糖尿病管理变化。
结果：我们确定了36,620和15,581名诊断为BC和RCC的个体，分别,2006年至2019年。在BC中，糖尿病患者的比例为24％，在RCC中为23％。发现BC/RCC与血糖控制不良之间存在关联，尽管医院护理中的血糖不良事件数量很少(糖尿病患者和BC/RCC患者中分别有65/59例,至少有1起事件).与2型糖尿病但没有癌症的匹配个体相比，在BC/RCC中观察到更早地转换为基于胰岛素的糖尿病管理。结果还表明类固醇治疗与血糖控制不良之间存在关联，与糖尿病对照组相比，全身性皮质类固醇在BC/RCC患者中更常见。
结论：在这项大型国家研究中观察到的糖尿病的高患病率和全身性皮质类固醇治疗的增加，突出了对特定临床管理的需求。风险评估，并监测BC/RCC和糖尿病患者。
方法：这项瑞典基于人群的回顾性登记研究使用国家健康数据登记来获取15年癌症发病率的纵向数据，使用以医院为基础的医疗保健，并填写了门诊药物的处方。研究终点包括BC/RCC个体中糖尿病的共同患病率，由于血糖不良而导致的医疗保健资源利用，使用全身性皮质类固醇，以及合并2型糖尿病患者的糖尿病管理变化。
结果：我们确定了36,620和15,581名诊断为BC和RCC的个体，分别,2006年至2019年。在BC中，糖尿病患者的比例为24％，在RCC中为23％。发现BC/RCC与血糖控制不良之间存在关联，尽管医院护理中的血糖不良事件数量很少(糖尿病患者和BC/RCC患者中分别有65/59例,至少有1起事件).与2型糖尿病但没有癌症的匹配个体相比，在BC/RCC中观察到更早地转换为基于胰岛素的糖尿病管理。结果还表明类固醇治疗与血糖控制不良之间存在关联，与糖尿病对照组相比，全身性皮质类固醇在BC/RCC患者中更常见。
结论：在这项大型国家研究中观察到的糖尿病的高患病率和全身性皮质类固醇治疗的增加，突出了对特定临床管理的需求。风险评估，并监测BC/RCC和糖尿病患者。
