Changes in Glucose level During Chemotherapy Treatment in Patients With Stage I-IV Breast Cancer.

Purpose: Glucose dysregulation may occur during chemotherapy treatment of patients with breast cancer. Absent appropriate management, patients may experience worsened morbidity and mortality. Mechanisms regarding glucose dysregulation are well-studied, but the role of chemotherapy is not. Previous studies of glucose dysregulation among patients undergoing chemotherapy have yielded inconsistent results.

Methods: We evaluate changes in blood glucose in women with breast cancer undergoing chemotherapy and explore effects of covariates. Records of 981 patients with stage I-IV breast cancer were evaluated, including blood glucose levels and other clinical and histopathological data. Patients were treated at The Ohio State University, an NCI-designated Comprehensive Cancer Center, from 2016 to 2018. Subgroups reflecting populations studied by previous reports were analyzed.

Results: Overall, blood glucose decreased slightly after chemotherapy versus baseline (131.3 mg/dL vs. 134.8 mg/dL, P = .048). Among patients with baseline random glucose levels lower than 125 mg/dL, levels increased versus baseline (113 vs 99 mg/dL, P < .001). Among patients younger than 70 and without diabetes mellitus, there was no statistically significant change (120 vs 122 mg/dL, P = .47). Adjusting for baseline variables including glucose levels, estimated change from baseline is higher among patients exposed to docetaxel/cyclophosphamide versus other regimens assessed (P < .001).

Conclusions: Random blood glucose decreased slightly during chemotherapy. Differences in results in previous reports are attributable to differing study populations. Baseline glucose levels, age, and chemotherapy regimen are predictors of change in glucose level.