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- Overweight and obesity
- Peripheral neuropathy
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IMPAIRED GLUCOSE METABOLISM AND DIABETES
This page is part of the PanCare PLAIN summaries about late effects and recommendations for long-term follow-up care for survivors of childhood, adolescent, and young adult cancer. Click here, for more information on the PLAIN summaries.
On this page you can find:
- Impaired glucose metabolism and diabetes
- Am I at higher risk of impaired glucose metabolism and diabetes?
- What are the symptoms and signs of a impaired glucose metabolism and diabetes?
- I am at higher risk of impaired glucose metabolism and diabetes. What tests should I have and when?
- What happens if I have a impaired glucose metabolism and diabetes?
- What else can I do?
- Where can I find more information?
- 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.
PLAIN version 2.1: 27/05/2024
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.
The pancreas and glucose metabolism
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Hormone
Survivors
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.
Autoimmune disease
Radiotherapy
Your treatment summary can tell you which areas of your body were irradiated. If you do not have a treatment summary or if you don’t understand what is written about the radiotherapy you received, do contact your treating hospital.
Radiotherapy is a treatment for cancer which uses high-energy radiation to destroy cancer cells and to shrink tumours. The radiation comes from a machine outside the body (external beam radiotherapy) or occasionally from radioactive material that is placed in the body near cancer cells (intracavitary or interstitial radiotherapy). The aim of radiotherapy is to treat only one area of the body, around and near the cancer or where the cancer was before it was removed by surgery and as far as possible to protect unaffected areas. For example, if you have cancer in your lung, you will have radiation only to your chest, not to your whole body.
External beam radiotherapy is painless and takes only a few minutes. It is given once or occasionally twice a day often for several weeks. A radiation beam is like an invisible light beam. The machines which produce the radiation beam can be moved so that the beam enters the body from different directions, ‘spotlighting’ on the area to be treated. This means that the tumour is given a high dose whilst normal areas get either a lower or no dose at all.
Since the early 1980’s computers and other technical advances have improved radiotherapy. Before this there were not many ways to protect normal tissues which were in the path of a radiation beam. Even now, whilst modern techniques allow doctors to target the cancer cells more precisely than older techniques, healthy cells may still get damaged. This can result in some of the late effects covered in the PLAIN summaries. It will help you and your follow up specialist to know what long term effects there might be after your radiotherapy if you and they have your treatment summary.
Your treatment summary can tell you which areas of your body were irradiated. If you do not have a treatment summary or if you don’t understand what is written about the radiotherapy you received, please contact your treating hospital.
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.
Symptoms and signs
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 and 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.
Healthy lifestyle
- Having a healthy diet
- Drinking less (or no) alcohol
- Exercising regularly
- Quitting smoking (if you smoke)
Your follow-up care specialist or general practitioner may give you additional advice tailored to your individual situation for maintaining a healthy lifestyle. For more information on taking up a healthier lifestyle, please read: Health promotion.
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:
- American National Institute of Health (NIH): Here you can find more information about diabetes in general
- Diabetes UK: Here you can find more information about diabetes in general
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.
The PanCare materials are free to use for anyone aiming to inform about late effects and long-term survivorship care. However, no financial advantage may be achieved. All communication should reference PanCare and link to the PanCare website.
[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