Case analysis of abnormal increase in blood glucose after targeted combination chemotherapy in a patient with colon cancer

Published on Jan. 15, 2024Total Views: 676 times Total Downloads: 938 times Download Mobile

Affiliation: 1. Department of Pharmacy, Suzhou Hospital of Integrated Traditional Chinese and Western Medicine, Suzhou 215101, Jiangsu Province, China 2. Department of Nephrology and Endocrinology, Suzhou Hospital of Integrated Traditional Chinese and Western Medicine, Suzhou 215101, Jiangsu Province, China

Keywords: Diabetic ketoacidosis High blood sugar Fluorouracil Bevacizumab

DOI: 10.12173/j.issn.1005-0698.202306063

Reference: WU Yan, WANG Xin.Case analysis of abnormal increase in blood glucose after targeted combination chemotherapy in a patient with colon cancer[J].Yaowu Liuxingbingxue Zazhi,2024, 33(2):230-235.DOI: 10.12173/j.issn.1005-0698.202306063.[Article in Chinese]  Copied

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Abstract

This article introduced a case of colon cancer patient who developed abdominal pain with nausea and vomiting after two cycles of using bevacizumab combined with fluorouracil. The perfect examination founded that the blood sugar rose abnormally to 40 mmol·L^-1, the pH of blood gas was 7.24, the actual bicarbonate was 4 mmol·L^-1, ketone body 3+, and urine sugar 3+. It was judged as mild diabetes ketoacidosis. After a large amount of fluid infusion, insulin treatment, and dual insulin treatment, The patient's blood gas analysis, ketone bodies, and urine sugar have all been normal, and their fasting blood sugar is controlled at 8.6 mmol·L^-1. The patient’s condition was stable while long term use of insulin aspart was necessary. According to the association evaluation method of the National ADR Monitoring Center, the author evaluated the association of diabetes ketoacidosis, and assessed that diabetes ketoacidosis "may" be caused by the combined use of bevacizumab and fluorouracil. Through consulting domestic and foreign literature, the author analyzed and summarized tumor related glucose metabolism abnormalities, realized that abnormal blood glucose caused by chemotherapy drugs or chemotherapy adjuvant drugs can not be ignored, especially in tumor patients with diabetes history or pre diabetes. Hope the analysis can provide a certain reference for similar reactions.

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References

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