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Predictors of Diabetes Self-Management in Older Adults Receiving Chemotherapy

Hershey, Denise Soltow PhD, FNP-BC; Given, Barbara PhD, RN, FAAN; Given, Charles PhD; Corser, William PhD, RN; Eye, Alexander von PhD

doi: 10.1097/NCC.0b013e3182888b14

Background: Cancer patients with diabetes have higher mortality rates and are more likely to develop infections, and be hospitalized during treatment. Hyperglycemia has been hypothesized as one of the factors associated with this increased risk. Diabetes self-management is one of the essential elements used by patients to maintain glucose levels.

Objective: This exploratory study seeks to develop an understanding of the impact cancer treatment can have on overall diabetes self-management and how individual, clinical, and behavioral characteristics may influence or predict the level of diabetes self-management in adults who are undergoing chemotherapy for a solid tumor cancer.

Methods: This study was conducted at 8 community-based cancer centers in Michigan and Ohio and used a written, self-administered survey at baseline and a phone survey 8 weeks later.

Results: Diabetes self-management significantly decreased (P < .001), and the level of symptom severity significantly increased (P < .001) after patients were on chemotherapy for a minimum of 8 weeks. The level of symptom severity and diabetes self-efficacy were significantly predictive of the performance of diabetes self-management activities.

Conclusions: Chemotherapy and associated symptoms can have a negative impact on the performance of diabetes self-management activities in adults with both diabetes and cancer, increasing the risk for hyperglycemia and development of complications.

Implications for Practice: Oncology nurses need to be aware of the impact cancer treatment can have on the performance of diabetes self-management activities in adults. Future research needs to test interventions that may assist patients with diabetes and cancer in managing both diseases.

Author Affiliations: College of Nursing (Drs Hershey and B. Given); Department of Family Medicine (Dr C. Given) and Institute for Health Care Studies (Dr. Corser), College of Human Medicine; and Department of Psychology (Dr von Eye), Michigan State University, East Lansing.

This project was supported by funding through an Alpha Psi Sigma Theta Tau Chapter Research Award and through a Michigan Nurse Corp Initiative Scholarship, provided by the Michigan Department of Community Health and Michigan Department of Labor and Economic Growth.

The authors have no conflicts of interest to disclose.

Correspondence: Denise Soltow Hershey, PhD, FNP-BC, College of Nursing, Michigan State University, C341 Bott Building for Nursing Education and Research, 1355 Bogue St, East Lansing, MI 48824 (

Accepted for publication January 4, 2013.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins