Study On Chemotherapy-induced Glucose Metabolic Disorders And Function Of β　Cell Of Islet In Elderly Patients With Colorectal Carcinoma

Objective:To evaluate the influence of chemotherapy on glucose metabolism and on function of β Cell of islet in elderly patients with colorectal carcinoma.Method:We selected37elderly patients with colorectal cancer from August2013to March2014. Fasting blood glucose, plasma insulin and C-peptide were performed along with routine pre-chemotherapy blood tests, at four pre-specified time points:before commencement of chemotherapy, during the therapy after2or4and6months.Results:A total of7patients (18.92%) were developed clinically significant hyperglycemia after6months (P<0.05). Of these,5patients (13.51%) were developed impaired fasting glucose,2patients (5.41%) were developed diabetes mellitus.5-FU based chemotherapy did not seem to have more opportunity to induce the incidence of hyperglycemia than capecitabine based chemotherapy (P>0.05). The two chemotherapy both could elevate fasting blood glucose level of the patients, but there were not different (P>0.05). ALL patients had gradually elevated fasting blood glucose with time increases of chemotherapy (P>0.05). The fasting plasma insulin and HOMA-IR after6months were more elevated than that before chemotherapy in32patients (P<0.05). The C-peptide and HOMA-%β were no differences between commencement of chemotherapy and after6months.Conclusions:These results suggest that chemotherapy can induce glucose metabolic disorders in elderly patients with colorectal carcinoma. Chemotherapy may cause fasting plasma insulin rise and insulin resistance.