Background: Both diabetes and cancer are major global health issues that are among the leading causes of morbidity and mortality. There is a high prevalence of diabetes among cancer patients, many of whom require a surgical procedure. This review focuses on the operative complications in patients with diabetes and cancer, and the perioperative management of diabetes in cancer patients. Methodology: A literature search of articles in English—published between January 2010 and May 2024—was carried out using the databases PubMed, MEDLINE, Google Scholar, and the Cochrane Database of Systematic Reviews. The search primarily focused on the operative complications in patients with diabetes and cancer, and perioperative management strategies. Results: The relationship between cancer and diabetes is complex; cancer patients have a high risk of developing diabetes, while diabetes is a risk factor for certain cancers. In addition, various cancer therapies can induce or worsen diabetes in susceptible patients. Many individuals with cancer and diabetes require surgery, and due to underlying diabetes, they may have elevated risks for operative complications. Optimal perioperative management for these patients includes managing perioperative glycemia and other comorbid illnesses, adjusting diabetic and cancer treatments, optimizing nutrition, minimizing the duration of fasting, supporting early mobilization, and providing patient education to enable self-management. Conclusions: While evidence is limited, optimal perioperative management for patients with both diabetes and cancer is necessary in order to reduce surgical complications. Future studies are needed to develop evidence-informed perioperative strategies and improve outcomes for these patients.
背景：糖尿病与癌症均为全球重大健康问题，是导致发病和死亡的主要原因。癌症患者中糖尿病患病率较高，其中许多患者需接受外科手术。本综述聚焦于糖尿病合并癌症患者的手术并发症及其围手术期糖尿病管理。方法：通过PubMed、MEDLINE、Google Scholar及Cochrane系统评价数据库，检索2010年1月至2024年5月期间发表的英文文献，重点探讨糖尿病合并癌症患者的手术并发症及围手术期管理策略。结果：癌症与糖尿病之间存在复杂关联：癌症患者罹患糖尿病风险较高，而糖尿病又是某些癌症的危险因素。此外，多种癌症治疗可能诱发或加重易感患者的糖尿病。许多糖尿病合并癌症患者需接受手术治疗，且因基础糖尿病状态可能增加手术并发症风险。针对此类患者的最佳围手术期管理包括：控制围手术期血糖与其他合并症、调整糖尿病与癌症治疗方案、优化营养支持、缩短禁食时间、促进早期活动，并通过患者教育提升自我管理能力。结论：尽管现有证据有限，但对糖尿病合并癌症患者实施规范的围手术期管理对降低手术并发症至关重要。未来需开展更多研究以制定循证支持的围手术期策略，改善此类患者的临床结局。
Perioperative Management of Patients with Diabetes and Cancer: Challenges and Opportunities
肿瘤(癌症)患者之家