IMPAIRED GLUCOSE METABOLISM AND DIABETES

Impaired glucose metabolism and diabetes

The amount of glucose (sugar) in our blood is controlled and kept within normal values by a hormone called insulin. Insulin is produced by the pancreas, an organ in the upper abdomen, just behind the stomach.

When we eat, the amount of glucose in the blood rises. In response, the pancreas releases insulin. Insulin helps muscles and other cells to take up glucose from the bloodstream. As a result, the glucose level in the blood returns to normal levels.

Damage to the pancreas can cause it to stop producing (enough) insulin. This is called impaired glucose metabolism (or prediabetes). When the body needs more insulin than the pancreas can produce, this is called diabetes.

When your blood glucose is constantly too high, this can damage the blood vessels. In turn, this can lead to eye, nerve and kidney problems. Diabetes can also increase the risk of heart disease and stroke. With the right treatment and care, people with diabetes can live a healthy life with much less risk of experiencing these complications.

Most survivors do not develop impaired glucose metabolism or diabetes. You cannot reverse any damage to your pancreas but there are a number of things anyone can do that may lower your risk of developing impaired glucose metabolism and diabetes, such as exercising regularly and adopting or maintaining a healthy diet and weight.

Am I at higher risk of impaired glucose metabolism and diabetes?

Anyone, including people who have never had cancer treatment, may develop impaired glucose metabolism or diabetes. However, there are some cancer treatments that may increase the risk of having impaired glucose metabolism or diabetes later in life.

The following treatment can increase the risk of impaired glucose metabolism or diabetes:

  • Radiotherapy to the pancreas or an area that includes the pancreas

You can find out if you have received radiotherapy to the pancreas by looking at your treatment summary. If you do not have a treatment summary or if you have any questions, do contact your treating hospital.

If you experience impaired glucose metabolism or diabetes, it does not always mean that this is caused by cancer treatment. Impaired glucose metabolism and diabetes may have other causes, such as an autoimmune disease. You are at higher risk of developing impaired glucose metabolism or diabetes as you get older or if you are overweight. For more information on overweight and obesity, please read: Overweight and obesity . Your risk is also higher if impaired glucose metabolism or diabetes is common in your family and/or if you are of African-Caribbean, Black African, or South Asian ethnicity.

What are the symptoms and signs of impaired glucose metabolism and diabetes?

There are symptoms and signs that can tell you that you might have impaired glucose metabolism or diabetes. You might not have these symptoms and signs at the moment, but it is important to be aware of them in case they may develop in the future.

These symptoms and signs may suggest that you have impaired glucose metabolism or diabetes:

  • Passing a lot of urine
  • Increased thirst
  • Feeling more tired than usual
  • Losing weight without trying
  • Genital itching or thrush
  • Dizziness, blurred vision
  • Increased hunger
  • Repeated infections

If you experience any of these symptoms or signs for a longer period of time, please contact your general practitioner or follow-up care specialist.

It is also possible to have impaired glucose metabolism without experiencing any symptoms. Your general practitioner or follow-up care specialist can measure your blood glucose levels by doing a blood test.

I am at higher risk of impaired glucose metabolism and diabetes. What tests should I have and when?

If you are at higher risk of impaired glucose metabolism or diabetes, it is advised to have a blood test at least every 5 years. Your general practitioner or follow-up care specialist may order:

  • A fasting blood test to measure the glucose level in the blood. This blood test is usually done in the morning, before you eat breakfast.
  • An HbA1c blood test, which measures your average blood sugar levels in the last two to three months.

What happens if I have impaired glucose metabolism and diabetes?

If you have impaired glucose metabolism or diabetes, your general practitioner or follow-up care specialist will probably refer you to a:

  • Specialist in diabetes care

The specialist may discuss different treatment options with you. You may be advised to change your diet and increase your activity levels. Some people may be offered a referral to a dietician or therapist for help with this. You may also be prescribed medication to lower your blood sugar level.

You may also be advised to have your weight, blood pressure, blood lipids including cholesterol (a fatty substance in the blood) measured regularly. When you have impaired glucose metabolism or diabetes, it is important to be aware of other factors that may influence your risk of (future) problems with the heart or blood vessels. For more information on overweight and obesity, high blood pressure or dyslipidaemia, please read: Overweight and obesity, hypertension, dyslipidaemia.

What else can I do?

Knowing that you may be at increased risk of impaired glucose metabolism or diabetes can be difficult. Talking to friends and family can be helpful as well as specialist counselling and/or contact with support groups, such as patient organisations. For more information on taking care of your mental health, please read: Mental health problems.

To lower your risk of impaired glucose metabolism or diabetes, adopting or maintaining a healthy lifestyle is important. Taking care of your mental health may be beneficial; even small changes to your lifestyle can have a positive impact on both your physical and mental health. For more information on taking up a healthier lifestyle, please read: Health promotion.

It is important that you are aware of the possibility of developing impaired glucose metabolism or diabetes and that you know the symptoms and signs. If you have any further questions or if the information in this brochure worries you, please contact your general practitioner or follow-up care specialist.

Where can I find more information?

You may find more information about impaired glucose metabolism or diabetes online. However, it is important to be aware that this information is not always up to date or accurate.

Some sources of further information are:

On this website, you can also find more information related to this topic:

Please note

This PLAIN summary is based on the PanCareFollowUp guideline about “Impaired glucose metabolism and diabetes” [1], which is based on the consensus of different national guidelines.

While the PanCare PLAIN information group strives to provide accurate and complete information that is up-to-date as of the date of publication, you can check with your general practitioner or follow-up care specialist if this summary reflects the most up-to-date information available and whether it is relevant for you.

Please do not rely solely on this information. It is best to also seek the advice of a qualified medical practitioner if you have questions regarding a specific medical condition, disease, diagnosis or symptom.

No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information. PanCare has produced the English version and PanCare is not responsible for the translated versions of this summary.

[1] van Kalsbeek, R. et al. (2021) European PANCAREFOLLOWUP recommendations for surveillance of late effects of childhood, adolescent, and Young Adult Cancer, European journal of cancer. Available at: https://www.ejcancer.com/article/S0959-8049(21)00368-3/fulltext