Education on Diabetes in Breast Cancer Survivors Needed for Self-Management

Diabetes may be a risk factor for increased symptoms among breast cancer survivors, particularly for physical and cognitive function, sleep and fatigue, according to secondary analysis results presented at the Oncology Nursing Society’s 44th Annual Congress.

“Women with diabetes have a 23% higher risk of developing breast cancer than women without diabetes, and up to 33% of breast cancer survivors have diabetes,” the researchers wrote in the abstract. “Both diseases result in common symptoms affecting quality of life including depression, anxiety, fatigue, pain, peripheral neuropathy and changes in sexual, physical and cognitive function. Diabetes may exacerbate breast cancer survivors’ symptoms. As breast cancer survivors are living longer, the role of comorbidities on their long-term symptom profile is important to address.”

The researchers aimed to compare symptoms — such as depression, anxiety, sexual function, peripheral neuropathy, physical function, attention function, sleep disturbance and fatigue – among breast cancer survivors with and without comorbid diabetes. In addition, they examined if a diabetes diagnosis was associated with higher symptom profiles in women with breast cancer.

Using a large, cross-sectional study, data were collected from 97 sites across the United States to identify 1,127 breast cancer survivors.

In total, 121 patients reported with diabetes and 1,006 without. Of those with diabetes, the majority tended to be older (62 years vs. 57 years), had higher body mass indexes (BMIs; 32 vs. 28), income lower than $75,000 (72% vs. 56%) and were less likely to be married (62% vs. 76%) compared to those without the comorbidity.

Of the eight symptoms analyzed, breast cancer survivors with diabetes reported higher symptom scores for physical function (2.30 vs. 2.60), attention function (6.45 vs. 6.91), sleep (7.20 vs. 6.33) and fatigue (37.81 vs. 40.25) compared to survivors without diabetes. There were no significant associations with sexual function, anxiety, depression and peripheral neuropathy.

When the researchers controlled for demographic and medical variables, diabetes was associated with a higher symptom profile for the same four symptoms compared with breast cancer survivors without diabetes.

“Prospective studies are needed to examine the symptom profile of breast cancer survivors with diabetes throughout the cancer trajectory,” the researchers wrote. “If problematic symptoms are identified, treatment plans can be implemented to decrease symptom burden and increase quality of life.”