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Cancer and Diabetes: Managing a Dual Diagnosis
If you are managing cancer and diabetes, you understand how difficult it can be. Each of these diseases can be frustrating enough to deal with on their own. When battling them at the same time, it can take your stress to new levels.
Regardless of which disease came first, know you are not the only one dealing with this situation. Cancer and diabetes often co-exist. And, while managing both diseases simultaneously can be difficult, it can be done. The first step is understanding.
Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone secreted by the pancreas (the large gland behind the stomach). Insulin is needed to convert sugar, starches and other carbohydrates into energy needed for daily life.
Much of the food you eat is broken down into glucose (sugar), which is the main source of fuel for the body. After digestion, glucose passes into the bloodstream and, with the help of insulin, it moves into the body’s cells where it provides fuel for metabolic processes.
If the pancreas produces little or no insulin, or if the body’s cells do not respond appropriately to the insulin that is produced, glucose accumulates in the blood. Thus, the body’s cells lose their main source of fuel. Also, when there is too much sugar in the blood for long periods of time, other cells become damaged.
While an estimated 14.6 million Americans (about seven percent of the U.S. population) have been diagnosed with diabetes, about 6.2 million people have the disease and don’t even realize it.
Types of Diabetes
There are two main types of diabetes, Type I and Type II. Some pregnant women can also get diabetes, which is called gestational diabetes.
Type I diabetes, formerly known as “juvenile-onset” diabetes or insulin dependence diabetes mellitus (IDDM), occurs when the pancreas produces little or no insulin. Type I diabetes can occur at any age, but it typically develops in people under the age of 30 (most commonly children). It accounts for about one out of 10 people with diabetes and is primarily treated with daily insulin injections.
Type II diabetes, sometimes called “adult-onset” diabetes or non-insulin dependent diabetes mellitus (NIDDM), is more common and occurs when the insulin produced by the pancreas does not work effectively. Type II diabetes is typically found in individuals who are over 30 years of age and overweight. It accounts for about nine out of 10 people with diabetes and can be managed with healthy eating, regular exercise, oral medications and/or insulin when necessary.
The Cancer-Diabetes Relationship
Between eight and 18 percent of people living with cancer also have diabetes. While many individuals know they are diabetic when they are diagnosed with cancer, others may only discover it after a cancer diagnosis or during treatment.
In addition, there is a strong link between diabetes and different types of cancer. Type I diabetes tends to occur with cervical and stomach cancers. Type II diabetes often occurs with breast, endometrial, pancreatic, liver, kidney, and colon cancers.
It is important to properly manage diabetes during cancer treatment. Cancer and cancer treatment can bring about metabolic changes that cause or aggravate symptoms of diabetes. Also, high blood sugar levels brought on by diabetes can weaken the immune system, which needs to be strong to fight cancer. Likewise, diabetes could potentially delay cancer treatment or increase the risk of infection during treatment.
Tips for Managing Diabetes During Cancer Treatment
Educate yourself. Try to educate yourself as much as possible about the disease and how it may impact your cancer treatment. By acquiring the knowledge and skills for managing the disease, you will be better able to take good care of yourself and prevent/minimize diabetes complications.
- Make a plan. Once you develop a plan for managing diabetes, it becomes easier to stay on top of it. You should discuss your goals for diabetes management with members of your healthcare team, including your doctors and dietitians. Taking an active role in your diabetes care will help you better manage the disease.
- Keep a balance. To keep your blood glucose at a healthy level and help fight fatigue during cancer treatment, it is important to stick to a daily routine/schedule. Try to properly balance nutrition/diet, exercise, glucose levels, and medication. Make sure you stay well hydrated and don’t skip meals. To prepare for times when you can’t have a regular meal, carry healthy snacks with you.
- Monitor your blood sugar. It is important that you keep your blood sugar levels under control. Some cancer treatments (e.g., steroids) can cause blood glucose levels to rise. Keeping your blood sugars within your target range may help avoid postponement of your cancer treatment and prevent infection, nausea, fatigue, and other issues.
- Monitor your blood pressure. Diabetes and high blood pressure can damage your blood vessels. High blood pressure can also impair your immune system, limiting your ability to fight off viruses that cause infection. To help keep blood pressure within the normal range, try to practice healthy habits like a balanced diet and regular exercise.
- Eat smart. To regulate your blood sugar levels, you should carefully manage what you eat, how much and when. This can be a challenge during cancer treatment if you feel nauseous or have difficulty keeping foods down. Try to balance carbohydrates, fat and protein. Choose whole fruits and vegetables, whole grains, and beans; and reduce the amount of white, refined products, simple sugars, cakes, and candy. A registered dietitian can help develop a healthy eating plan that’s right for you.
- Stay physically active. Regular exercise can help increase the efficiency of cells to uptake glucose and process it. Exercise may also help increase muscle, thereby reducing insulin resistance. It can also help to elevate your mood and relax you. A rehabilitation therapist can help develop an appropriate exercise program for you.
- Avoid unhealthy habits. If you have cancer and diabetes, the risks of smoking are even higher. Smoking further impairs your immune system, making you more susceptible to colds and respiratory infections. You should also avoid excessive alcohol consumption, which can dehydrate you and weaken your immune system as well.
- Manage your stress. No matter how well you’re coping, cancer and diabetes can create a lot of added stress. Stress can increase your body's production of the hormones that block the effect of insulin, causing your blood sugar to rise. Try different ways to reduce stress, such as relaxation techniques, distraction and massage.
- Talk about your feelings with others. Share your concerns with family and friends, as well as with others who are in similar situations. Consider joining a support group for people who are managing a dual diagnosis. Expressing yourself may help you feel less alone and improve your overall quality of life.
NOTE: THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTHCARE PROVIDER REGARDING YOUR CANCER TREATMENT AND DIABETES CARE.
Diabetes Care at CTCA
At Cancer Treatment Centers of America (CTCA), we understand you may be dealing with other health conditions aside from cancer, such as diabetes. The cancer-diabetes relationship is becoming more and more common. Last year alone, about 11 percent of cancer patients at CTCA at Southwestern Regional Medical Center were managing this dual diagnosis.
In an effort to address the comprehensive needs of our diabetic patients, CTCA at Southwestern offers a Diabetes Self-Management Education (DSME) Program. Accredited by the American Diabetes Association (ADA), the program was piloted in 1984. Since then, the ADA has recognized the DSME Program at CTCA for its outstanding care of diabetic cancer patients.
Led by registered dietitian Andrea Reser, the DSME Program at CTCA emphasizes the complex health needs of our cancer patients. It includes ongoing lifestyle coaching and monitoring to ensure your individualized cancer treatment is being managed appropriately alongside your diabetes. The program focuses on the diabetes disease process, sick day management, nutritional management, physical activity, use of medications, blood sugar monitoring, psychosocial interventions, and prevention of acute and chronic complications.
Cancer can be an overwhelming disease to overcome, particularly if you are managing diabetes at the same time. At CTCA, we are committed to whole-person care. We believe if we can lessen the challenges you face with managing diabetes, you will be better equipped to handle your cancer treatments and therapies. Thus, we provide comprehensive cancer care to help address your unique health needs and put you on a path towards healing.
I hope this information has helped you in some way. I will check in with you again next month. In the meantime, stay strong and hopeful.