Dietary Intervention Helps Pre-Diabetic Patients With Bladder Cancer

Patients with nonmuscle-invasive bladder cancer, either at risk for or diagnosed with diabetes, lowered their blood sugar levels following a carbohydrate-restricted diet, according to study results presented at the 2018 Genitourinary Cancers Symposium.

Patients with diabetes are at a greater risk for bladder cancer, and worse, for disease recurrence and progression.

“Even after controlling for clinical and pathologic risk factors, diabetes mellitus confers a two times greater risk of recurrence and nine times greater risk of progression,” researchers from the University of Kansas in Kansas City wrote.

Therefore, the researchers hypothesized that utilizing a carbohydrate-restricted diet of consuming less than 130 grams per day could decrease the bioavailability of glucose in patients with diabetes and bladder cancer and, in turn, have a potential therapeutic benefit.

The pilot study was designed to assess the feasibility of this diet in patients with pre-diabetes and nonmuscle-invasive bladder cancer receiving bacillus calmette-guerin (BCG) therapy — the main intravesical immunotherapy for treating early-stage bladder cancer.

Five patients were supplied with a carbohydrate-restricted diet for the first 12 weeks through a meal delivery service. Patients also received weekly coaching with a nutritionist for six weeks during induction BCG and again at the three-month surveillance cystoscopy with dietary and activity goals implemented.

Patients, who were an average of 66 years old, tracked their own diets, while two unannounced 24-hour diet recalls were also obtained to monitor compliance.

Overall, three patients had diabetes and two had pre-diabetes.

At baseline, the average level of blood sugar was 7.6 percent and average bodyweight was 92 kg with a BMI of 28.2.

Four of the five patients completed dietary logs and weekly labs, and three patients achieved their goal of consuming less than 130 grams of carbohydrates per day on a 24-hour dietary recall.

After three months, the average level of blood sugar improved to 6.6 percent.

“Eighty percent of patients completed dietary logs for the first three months of the trial; 60 percent achieved compliance with the carbohydrate restricted diet,” the researchers wrote. “These data demonstrate the feasibility of a dietary intervention utilizing carbohydrate restricted in patients with high-grade nonmuscle-invasive bladder cancer undergoing BCG.”