Paliatívna medicína a liečba bolesti 3/2009

Disorders of glucose metabolism in patients in palliative care

Diabetes mellitus is a common co-morbid condition in patiens with advanced cancer.Most of these patiens have type 2 diabetes. The goal of care for diabetes near the end of life is to primarly prevent symptoms of hyperglycemia and hypoglycemia. Target glukose concentration can be liberalised to 10–15 mmol/l. The diet should be liberalised as well. Patiens with type 1 diabetes will likely continue to require insulin therapy untill close to death to prevent diabetic ketoacidosis. Many achieve adequate glukose kontrol with once or twice daily injections of intermediate- or longacting insulin. Patients with type 2 diabetes may not require pharmacoterapeutic management as their apetite lessens and oral intake declines.

Keywords: diabetes mellitus, advanced disease, symptoms of hyperglycemia.