Diabetes management in cancer patients. An Italian Association of Medical Oncology, Italian Association of Medical Diabetologists, Italian Society of Diabetology, Italian Society of Endocrinology and Italian Society of Pharmacology multidisciplinary consensus position paper

N Silvestris¹, T Franchina², M Gallo³, A Argentiero⁴, A Avogaro⁵, G Cirino⁶, A Colao⁷, R Danesi⁸, G Di Cianni⁹, S D'Oronzo¹⁰, A Faggiano¹¹, S Fogli⁸, D Giuffrida¹², S Gori¹³, N Marrano¹⁴, R Mazzilli¹¹, M Monami¹⁵, M Montagnani¹⁶, L Morviducci¹⁷, A Natalicchio¹⁴, A Ragni³, V Renzelli¹⁸, A Russo¹⁹, L Sciacca²⁰, E Tuveri²¹, M C Zatelli²², F Giorgino¹⁴, S Cinieri²³

Affiliations

¹ Medical Oncology Unit, Department of Human Pathology "G. Barresi", University of Messina, Messina. Electronic address: nicola.silvestris@unime.it.
² Medical Oncology Unit, Department of Human Pathology "G. Barresi", University of Messina, Messina.
³ Endocrinology and Metabolic Diseases Unit, AO SS Antonio e Biagio e Cesare Arrigo of Alessandria, Alessandria.
⁴ Medical Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari.
⁵ Department of Medicine, University of Padova, Padua.
⁶ Department of Pharmacy, School of Medicine and Surgery, University of Naples Federico II, Naples.
⁷ Endocrinology, Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples; UNESCO Chair, Education for Health and Sustainable Development, Federico II University, Naples.
⁸ Unit of Clinical Pharmacology and Pharmacogenetics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa.
⁹ Diabetes Unit Livorno Hospital, Livorno.
¹⁰ Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari.
¹¹ Endocrinology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, ENETS Center of Excellence, Sapienza University of Rome, Rome.
¹² Department of Oncology, Istituto Oncologico del Mediterraneo, Viagrande, Catania.
¹³ Oncologia Medica, IRCCS Ospedale Don Calabria-Sacro Cuore di Negrar, Verona.
¹⁴ Department of Precision and Regenerative Medicine and Ionian Area, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari.
¹⁵ Diabetology, Careggi Hospital and University of Florence, Firenze.
¹⁶ Department of Precision and Regenerative Medicine and Ionian Area, Section of Pharmacology, Medical School, University of Bari Aldo Moro, Bari.
¹⁷ Diabetology and Nutrition Unit, Department of Medical Specialties, ASL Roma 1 - S, Spirito Hospital, Rome.
¹⁸ Diabetologist and Endocrinologist, Italian Association of Medical Diabetologists, Rome.
¹⁹ Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo.
²⁰ Department of Clinical and Experimental Medicine, Endocrinology Section, University of Catania, Catania.
²¹ Diabetology, Endocrinology and Metabolic Diseases Service, ASL-Sulcis, Carbonia.
²² Section of Endocrinology, Geriatrics, and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara.
²³ Medical Oncology Division and Breast Unit, Senatore Antonio Perrino Hospital, ASL Brindisi, Brindisi, Italy.

PMID: 38070434
PMCID: PMC10714217
DOI: 10.1016/j.esmoop.2023.102062

Review

Diabetes management in cancer patients. An Italian Association of Medical Oncology, Italian Association of Medical Diabetologists, Italian Society of Diabetology, Italian Society of Endocrinology and Italian Society of Pharmacology multidisciplinary consensus position paper

N Silvestris et al. ESMO Open. 2023 Dec.

. 2023 Dec;8(6):102062.

doi: 10.1016/j.esmoop.2023.102062. Epub 2023 Dec 8.

Authors

Affiliations

¹ Medical Oncology Unit, Department of Human Pathology "G. Barresi", University of Messina, Messina. Electronic address: nicola.silvestris@unime.it.
² Medical Oncology Unit, Department of Human Pathology "G. Barresi", University of Messina, Messina.
³ Endocrinology and Metabolic Diseases Unit, AO SS Antonio e Biagio e Cesare Arrigo of Alessandria, Alessandria.
⁴ Medical Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari.
⁵ Department of Medicine, University of Padova, Padua.
⁶ Department of Pharmacy, School of Medicine and Surgery, University of Naples Federico II, Naples.
⁷ Endocrinology, Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples; UNESCO Chair, Education for Health and Sustainable Development, Federico II University, Naples.
⁸ Unit of Clinical Pharmacology and Pharmacogenetics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa.
⁹ Diabetes Unit Livorno Hospital, Livorno.
¹⁰ Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari.
¹¹ Endocrinology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, ENETS Center of Excellence, Sapienza University of Rome, Rome.
¹² Department of Oncology, Istituto Oncologico del Mediterraneo, Viagrande, Catania.
¹³ Oncologia Medica, IRCCS Ospedale Don Calabria-Sacro Cuore di Negrar, Verona.
¹⁴ Department of Precision and Regenerative Medicine and Ionian Area, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari.
¹⁵ Diabetology, Careggi Hospital and University of Florence, Firenze.
¹⁶ Department of Precision and Regenerative Medicine and Ionian Area, Section of Pharmacology, Medical School, University of Bari Aldo Moro, Bari.
¹⁷ Diabetology and Nutrition Unit, Department of Medical Specialties, ASL Roma 1 - S, Spirito Hospital, Rome.
¹⁸ Diabetologist and Endocrinologist, Italian Association of Medical Diabetologists, Rome.
¹⁹ Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo.
²⁰ Department of Clinical and Experimental Medicine, Endocrinology Section, University of Catania, Catania.
²¹ Diabetology, Endocrinology and Metabolic Diseases Service, ASL-Sulcis, Carbonia.
²² Section of Endocrinology, Geriatrics, and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara.
²³ Medical Oncology Division and Breast Unit, Senatore Antonio Perrino Hospital, ASL Brindisi, Brindisi, Italy.

PMID: 38070434
PMCID: PMC10714217
DOI: 10.1016/j.esmoop.2023.102062

Abstract

Cancer management has significantly evolved in recent years, focusing on a multidisciplinary team approach to provide the best possible patient care and address the various comorbidities, toxicities, and complications that may arise during the patient's treatment journey. The co-occurrence of diabetes and cancer presents a significant challenge for health care professionals worldwide. Management of these conditions requires a holistic approach to improve patients' overall health, treatment outcomes, and quality of life, preventing diabetes complications and cancer treatment side-effects. In this article, a multidisciplinary panel of experts from different Italian scientific societies provide a critical overview of the co-management of cancer and diabetes, with an increasing focus on identifying a novel specialty field, 'diabeto-oncology', and suggest new co-management models of cancer patients with diabetes to improve their care. To better support cancer patients with diabetes and ensure high levels of coordinated care between oncologists and diabetologists, 'diabeto-oncology' could represent a new specialized field that combines specific expertise, skills, and training.

Keywords: cancer; diabetes mellitus; diabeto-oncology; multidisciplinary approach.

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Conflict of interest statement

The authors have declared no conflicts of interest.

Figures

**Figure 1**
Diabetes and cancer interplay across the therapeutic cancer patient journey: key points and challenges.

**Figure 2**
Specific areas of oncology and diabetology for the training in diabeto-oncology.

See this image and copyright information in PMC

References

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1. Gallo M., Clemente G., Cristiano Corsi D., et al. An integrated care pathway for cancer patients with diabetes: a proposal from the Italian experience. Diabetes Res Clin Pract. 2020;159 - PubMed
1. Giovannucci E., Harlan D.M., Archer M.C., et al. Diabetes and cancer: a consensus report. Diabetes Care. 2010;33(7):1674–1685. - PMC - PubMed
1. Natalicchio A., Montagnani M., Gallo M., et al. MiRNA dysregulation underlying common pathways in type 2 diabetes and cancer development: an Italian Association of Medical Oncology (AIOM)/Italian Association of Medical Diabetologists (AMD)/Italian Society of Diabetology (SID)/Italian Society of Endocrinology (SIE)/Italian Society of Pharmacology (SIF) multidisciplinary critical view. ESMO Open. 2023;8(3) - PMC - PubMed
1. Wang M., Yang Y., Liao Z. Diabetes, and cancer: epidemiological and biological links. World J Diabetes. 2020;11(6):227–238. - PMC - PubMed

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Diabetes management in cancer patients. An Italian Association of Medical Oncology, Italian Association of Medical Diabetologists, Italian Society of Diabetology, Italian Society of Endocrinology and Italian Society of Pharmacology multidisciplinary consensus position paper

Affiliations

Diabetes management in cancer patients. An Italian Association of Medical Oncology, Italian Association of Medical Diabetologists, Italian Society of Diabetology, Italian Society of Endocrinology and Italian Society of Pharmacology multidisciplinary consensus position paper

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical