I Was Diagnosed with Cancer and I have Diabetes. What Should I Do?
Did you know that November is National Diabetes Awareness Month? Approximately 1.6 million new cases of diabetes are diagnosed each year. Additionally, 1.4 million new cases of cancer are also diagnosed each year. You may think this is just a coincidence, but new evidence suggests that both cancer and diabetes may actually be more interrelated than just by mere chance. Specifically, large studies have even shown higher incidence of cancers such as colorectal, pancreatic, breast, bladder, and endometrial in individuals with diabetes.
For individuals who have diabetes and have recently been diagnosed with cancer, it may seem impossible to manage both. It is true that you may have to take some extra precautions to help manage your blood sugars while undergoing cancer treatment, but by following these few guidelines you can minimize your risk of complications.
- Check your blood sugar often.
If you do not have a glucose meter, ask your health care team, such as your physician, nurse, dietitian, or pharmacist for advice on purchasing one. The best time to check your blood sugar is in the morning, after meals, and before bed. Your healthcare team can help guide you with a glucose monitoring schedule that is appropriate and individualized for you.
- Be sure to communicate with your oncologist about your diabetes diagnosis and any complications you have experienced with diabetes.
It’s best to discuss these concerns with your oncologist before starting treatment. Diabetes can cause problems with your eyes, kidneys, heart, and circulation. If you have any of the following: such as trouble seeing, tingling/numbness in your feet or hands, heart conditions, protein in your urine, be sure to let your physician know.
- Take your diabetes medications as instructed by your doctor.
Do not stop any medications for diabetes unless instructed by your healthcare team. Take all diabetes medications as they were prescribed. Always discuss any changes in your blood sugar with your healthcare team. Let them guide you as to how to adjust dosing, if necessary.
- Manage nausea and vomiting.
Chemotherapy may cause nausea and vomiting. This will have an effect on your blood sugar. It is very important to take anti-nausea medications as prescribed. You will feel much better during treatment if you are able to eat and drink at regular intervals. A registered dietitian can also give you tips to help with nausea and vomiting.
- Manage high blood sugar caused by steroids.
Certain chemotherapy regimens require a pre-treatment medication to counteract side effects. Some of these pre-treatment medications are steroids. Steroids have the potential to increase blood sugar levels and cause swelling due to water retention. While on the steroids, continue to monitor your blood sugar and eat as healthy as possible while avoiding excessive desserts and other high sugar foods and beverages. Drink more water to help with the fluid retention. Sometimes your healthcare team will prescribe an additional medication such as insulin to help control elevated blood sugar levels.
- Eat as healthy and balanced as possible during cancer treatment.
When feeling well, continue to follow a healthy diabetes meal plan. If you are not certain what a healthy diabetes meal plan is for you, consult with a registered dietitian or a certified diabetes educator. They can show you how to eat the optimal amounts of protein, carbohydrate, and fat at each meal to help you control your blood sugar.
- Drink plenty of fluids (preferably water) throughout treatment.
Chemotherapy and other medications given during treatment can be hard on the kidneys and liver. It is important to drink plenty of fluids with a preference to water during treatment. This will help your body to flush out the medications in a timely manner. Staying well hydrated also helps in the management of nausea and vomiting.
- Be as active as possible.
Physical activity helps your body use the sugar in your blood more efficiently. However, if your blood sugar is too high (over 300mg/dL), or too low (less than 100mg/dL), do not participate in strenuous physical activity. If your blood sugar is low, you may be able to have a snack before exercising. We recommend that you discuss with your healthcare team on specific guidelines for your blood sugar goals during exercise and on the type and amount of exercise that is safe for you.
- Do not be overly restrictive with your diet.
Sometimes blood sugar levels rise due to reasons other than the food you eat. Increased blood sugar can be a response to stress on the body as well as the result of a medication such as steroids. Continue to eat a balanced diet and drink plenty of water if your blood sugar remains high for no apparent reason. Call your doctor or ask a member of your health care team for additional advice and/or medication changes. They can also give you specific blood glucose goals and tell you at what point you should call the doctor to report high blood sugar levels.
If you have specific questions regarding any of the guidelines, please contact the registered dietitians at The Minnie Pearl Cancer Foundation. We provide one-on-one nutrition guidance and will make more specific recommendations based on cancer type and current nutrition status. Click here to begin your personalized, one-on-one guidance.
*Sources: American Diabetes Association and Mayo Clinic
Blog Post Submitted by Jen Hartman, Dietitian at MPCF