Optimal glycemic target level for colon cancer patients with diabetes

- Colon cancer patients with DM had higher mortality risk compared to without DM.
- Uncontrolled DM had higher mortality risk compared to well-controlled DM.
- A target level of HbA1c for colon cancer patients with DM should be lower than 7.8%.

AimsThe aim of this study was to evaluate the differences in mortality among colon cancer patients with or without diabetes and to determine optimal glycemic target level for colon cancer patients with diabetes.MethodsA total of 741 patients with colon cancer between April 1999 and December 2010 were reviewed. The non-diabetes group had a fasting plasma glucose <126 mg/dL, and the diabetes group had a fasting plasma glucose ⩾126 mg/dL. Patients with diabetes were further divided based on glycemic control into either the uncontrolled subgroup (HbA1c ⩾8%) or the well-controlled subgroup (HbA1c <8%).ResultsPatients with diabetes had significantly shorter overall survival and median survival than non-diabetes patients. Uncontrolled diabetes patients had significantly shorter overall survival and median survival than well-controlled diabetes patients. The relative risk of mortality for diabetes patients was higher than non-diabetes patients (relative risk 1.17). The relative risk of mortality in uncontrolled diabetes patients was significantly higher than in well-controlled diabetes patients (relative risk 4.58). The area under the curve for mortality and HbA1c level was 0.73. The cut off HbA1c level was 7.75%.ConclusionsA optimal glycemic control level for colon cancer patients with diabetes should be recommended as an HbA1c of 7.8% or below.