A study from St. Jude Children’s Research Hospital sheds light on the incidence of prediabetes and diabetes in childhood cancer survivors for better prevention and treatment.
At a younger age, childhood cancer survivors can experience chronic conditions such as diabetes, typically associated with older individuals. Researchers found survivors have twice the risk of developing prediabetes than the general public, which increases their risk of other life-threatening diseases. In the general population, prediabetes can be modified with lifestyle and other interventions, suggesting the potential to improve survivors’ life- and health-spans. The results were published in the Journal of Clinical Oncology.
Prediabetes occurs when a person has higher than normal blood sugar levels but not high enough to be considered diabetic. A large percentage of people with prediabetes will later develop diabetes, which is associated with an increased risk of heart and kidney disease. In the general public, prediabetes can be managed through lifestyle changes, such as a healthy diet and exercise, as well as medication to prevent progression to diabetes and downstream conditions. The study suggests this approach may benefit survivors; however, optimal strategies to reduce the progression toward diabetes among prediabetic survivors remain unknown.
Blood sugar levels are well-known to vary naturally. Therefore, physicians may not discuss small elevations with survivors. The findings suggest that even small increases in blood sugar levels should be taken as a sign to start lifestyle interventions in survivors to protect their hearts and kidneys. The key to preventing disease will be identifying survivors with prediabetes as early as possible.
Cardiovascular disease commonly occurs in people with diabetes, but it was unclear if that risk was the same in younger survivors. The findings showed survivors with diabetes are at twice the risk of a heart attack event compared to those with normal blood sugar levels. This impact remained even when accounting for potential organ damage during cancer treatment.
In addition to cardiovascular risk, chronic kidney disease was particularly concerning. The researchers observed a three times greater risk of chronic kidney disease in survivors with prediabetes or diabetes.
