Prevalence of type 2 diabetes diagnoses in the perioperative and survivorship periods following surgical management of endometrial cancer: An opportunity for screening and intervention?

Molly Morton; Eric M McLaughlin; Corinne A Calo; Michelle Lightfoot; Kristin L Bixel; David E Cohn; Casey M Cosgrove; Larry J Copeland; David M O'Malley; Christa I Nagel; Laura M Chambers

doi:10.1016/j.ygyno.2023.08.009

Prevalence of type 2 diabetes diagnoses in the perioperative and survivorship periods following surgical management of endometrial cancer: An opportunity for screening and intervention?

Gynecol Oncol. 2023 Oct:177:46-52. doi: 10.1016/j.ygyno.2023.08.009. Epub 2023 Aug 26.

Authors

Affiliations

¹ Division of Gynecologic Oncology, The Ohio State University Wexner Medical Center, The James Cancer Hospital and Solove Research Institute, Starling Loving Hall, M210, 320 W. 10(th) Avenue, Columbus, OH 43210, USA. Electronic address: molly.morton@osumc.edu.
² Center for Biostatistics, The Ohio State University, Columbus, OH 43210, USA.
³ Division of Gynecologic Oncology, OhioHealth, Columbus, OH, USA.
⁴ Division of Gynecologic Oncology, New York University, New York, NY, USA.
⁵ Division of Gynecologic Oncology, The Ohio State University Wexner Medical Center, The James Cancer Hospital and Solove Research Institute, Starling Loving Hall, M210, 320 W. 10(th) Avenue, Columbus, OH 43210, USA.

PMID: 37639902
DOI: 10.1016/j.ygyno.2023.08.009

Abstract

Objective: To determine the prevalence of Type 2 diabetes mellitus (T2DM) diagnoses during the peri-operative and survivorship periods in patients following surgical management of endometrial cancer (EC).

Methods: An IRB-approved, retrospective single-institution cohort study was performed in patients who underwent surgical management of EC from 2014 to 2020. The perioperative period was defined as the 30 days before and after surgery. T2DM diagnoses occurring during survivorship were recorded. T2DM diagnoses were defined by a HgbA1c ≥6.5% or a random blood glucose ≥200 mg/dL. Sequelae of peri-operative T2DM and predictors of future T2DM were examined utilizing univariate analysis.

Results: Of 519 patients meeting inclusion criteria, 37 (7.1%) were diagnosed with T2DM in the perioperative period. Patients diagnosed with T2DM in the perioperative period had significantly higher BMI (p = 0.006) compared to no T2DM, but there were no significant differences in age (p = 0.20), ethnicity/race (p > 0.05) or ECOG score (p = 0.19). The rates of intraoperative complications between groups did not significantly differ, except for vascular complications (p = 0.005), and the incidence of any postoperative complication was higher in the perioperative T2DM group (p = 0.01). With a median follow-up of 29 months [range 11.6-49.0 months], an additional 18.3% (n = 88) of the cohort met diagnostic criteria for T2DM. BMI (p < 0.001), perioperative glucose (p < 0.001), and HgbA1c (p = 0.002) demonstrate risk for a T2DM diagnosis during survivorship.

Conclusion(s): In this retrospective cohort of EC patients, 25.4% were diagnosed with T2DM, with the majority diagnosed in the survivorship period. Surgical management and subsequent surveillance of EC presents an opportunity to diagnose at-risk patients with T2DM.

Keywords: Endometrial cancer; Survivorship; Type 2 diabetes mellitus.