Amber S Kleckner1, Ian R Kleckner2, Eva Culakova3, Michelle Shayne4, Elizabeth K Belcher5, Abdi T Gudina3, AnnaLynn M Williams6, Adedayo A Onitilo7, Judith O Hopkins8, Howard Gross9, Karen M Mustian3, Luke J Peppone3, Michelle C Janelsins10. 1. Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, 655 W. Lombard Ave., 7th floor, Baltimore, MD, 21201, USA. amber.kleckner@umaryland.edu. 2. Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, 655 W. Lombard Ave., 7th floor, Baltimore, MD, 21201, USA. 3. Division of Supportive Care in Cancer, Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA. 4. Department of Medicine, University of Rochester Medical Center, 265 Crittenden Blvd. CU 420658, Rochester, NY, 14642, USA. 5. Department of Psychological Science, Hobart and William Smith Colleges, Geneva, NY, USA. 6. Department of Epidemiology & Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA. 7. Wisconsin NCORP, Marshfield Medical Center, Weston, WI, USA. 8. Southeast Clinical Oncology Research (SCOR) Consortium, Winston-Salem, Weston, NC, USA. 9. Dayton Clinical Oncology Program, Dayton, OH, USA. 10. Division of Supportive Care in Cancer, Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA. michelle_janelsins@urmc.rochester.edu.
Abstract
PURPOSE: To quantify the relationship between diabetes and fatigue from pre-chemotherapy to 6 months post-chemotherapy for women with breast cancer compared to women without a history of cancer (controls). METHODS: This was a secondary analysis from a nationwide prospective longitudinal study of female patients with breast cancer undergoing chemotherapy and controls. Diabetes diagnosis (yes/no) was obtained at baseline, and cancer-related fatigue was measured using the Multidimensional Fatigue Symptom Inventory (MFSI) pre-, post-, and 6 months post-chemotherapy in patients; controls were assessed at equivalent time points. Repeated measures mixed effects models estimated the association between fatigue and diabetes controlling for cancer (yes/no), body mass index, exercise and smoking habits, baseline anxiety and depressive symptoms, menopausal status, marital status, race, and education. RESULTS: Among 439 patients and 235 controls (52.8 ± 10.5 years old), diabetes was twice as prevalent among patients as controls (11.6% vs. 6.8%). At baseline, diabetes was associated with worse fatigue (4.1 ± 1.7 points, p = 0.017). Also, diabetes was associated with clinically meaningful worse fatigue throughout the study period among all participants (5.2 ± 1.9 points, p = 0.008) and patients alone (4.5 ± 2.0, p = 0.023). For the MFSI subdomains among patients, diabetes was associated with worse general (p = 0.005) and mental fatigue (p = 0.026). CONCLUSIONS: Diabetes was twice as prevalent in women with breast cancer compared to controls, and diabetes was associated with more severe cancer-related fatigue in patients before and after chemotherapy and at 6 months post-chemotherapy. Interventions that address diabetes management may also help address cancer-related fatigue during chemotherapy treatment. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01382082, first posted June 27, 2011.
PURPOSE: To quantify the relationship between diabetes and fatigue from pre-chemotherapy to 6 months post-chemotherapy for women with breast cancer compared to women without a history of cancer (controls). METHODS: This was a secondary analysis from a nationwide prospective longitudinal study of female patients with breast cancer undergoing chemotherapy and controls. Diabetes diagnosis (yes/no) was obtained at baseline, and cancer-related fatigue was measured using the Multidimensional Fatigue Symptom Inventory (MFSI) pre-, post-, and 6 months post-chemotherapy in patients; controls were assessed at equivalent time points. Repeated measures mixed effects models estimated the association between fatigue and diabetes controlling for cancer (yes/no), body mass index, exercise and smoking habits, baseline anxiety and depressive symptoms, menopausal status, marital status, race, and education. RESULTS: Among 439 patients and 235 controls (52.8 ± 10.5 years old), diabetes was twice as prevalent among patients as controls (11.6% vs. 6.8%). At baseline, diabetes was associated with worse fatigue (4.1 ± 1.7 points, p = 0.017). Also, diabetes was associated with clinically meaningful worse fatigue throughout the study period among all participants (5.2 ± 1.9 points, p = 0.008) and patients alone (4.5 ± 2.0, p = 0.023). For the MFSI subdomains among patients, diabetes was associated with worse general (p = 0.005) and mental fatigue (p = 0.026). CONCLUSIONS: Diabetes was twice as prevalent in women with breast cancer compared to controls, and diabetes was associated with more severe cancer-related fatigue in patients before and after chemotherapy and at 6 months post-chemotherapy. Interventions that address diabetes management may also help address cancer-related fatigue during chemotherapy treatment. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01382082, first posted June 27, 2011.
Authors: Susan Storey; Andrea Cohee; Wambui G Gathirua-Mwangi; Eric Vachon; Patrick Monahan; Julie Otte; Timothy E Stump; David Cella; Victoria Champion Journal: Oncol Nurs Forum Date: 2019-07-01 Impact factor: 2.172