A nurse-led intervention in patients with newly diagnosed cancer and Type 2 diabetes: A pilot randomized controlled trial feasibility study

Cancer Med. 2023 Jun;12(11):12874-12880. doi: 10.1002/cam4.6118. Epub 2023 May 22.

Abstract

Background: Undiagnosed Type 2 diabetes (T2D) has been associated with advanced stage cancer at diagnosis, higher mortality, and lower long-term all-cause survival. This was a RCT pilot study to examine the feasibility of a nurse-led T2D intervention for adults with newly diagnosed cancer (≤3 months), and T2D, undiagnosed or untreated with medication, conducted at an outpatient oncology clinic affiliated with a large academic institution.

Methods: Participants needed to meet the eligibility criteria including a HbA1c level between 6.5% and 9.9%. Randomization was 1:1 to a 3-month intervention that consisted of nursing-led diabetes education and immediate initiation of metformin versus referral to primary care for usual care (control).

Results: Three hundred and seventy nine patients were screened using EHR, 55 agreed to participate, and 3 had eligible HbA1c levels and were randomized in the study. Primary reasons for study exclusion included life expectancy ≤2 years (16.9%), current use or inability to tolerate metformin (14.8%), and abnormal labs that contraindicated metformin use (13.9%).

Conclusion: This study was not feasible due to recruitment inefficiencies, but acceptable to all who qualified.

Keywords: clinical management; clinical trials; community outreach; medical oncology; screening.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Diabetes Mellitus, Type 2* / diagnosis
  • Diabetes Mellitus, Type 2* / drug therapy
  • Feasibility Studies
  • Glycated Hemoglobin
  • Humans
  • Metformin* / therapeutic use
  • Neoplasms* / diagnosis
  • Neoplasms* / drug therapy
  • Nurse's Role
  • Pilot Projects

Substances

  • Glycated Hemoglobin
  • Metformin