Measurement of hyperglycemia and impact on health outcomes in people with cancer: Challenges and opportunities

Problem Identifcation: Poor health outcomes have been associated with hyperglycemia in patients with and without diabetes. However, the impact of hyperglycemia on the healthrelated outcomes of patients with cancer has shown conflicting results. The purpose of this review was to explore defnitions and measurement issues related to the assessment of hyperglycemia and the subsequent impact on the fndings of health-related outcomes in adults with cancer. Literature Search: Four electronic databases were searched: MEDLINE®, PubMed, CINAHL®, and Web of Science. The search terms were cancer, hyperglycemia, measurement, adults, and health-related outcomes. Only quantitative manuscripts were reviewed. Articles that focused globally on diabetes, hyperglycemia, and/or cancer that did not discuss health-related outcomes were excluded from this review. Data Evaluation: A total of 30 articles were reviewed. Quantitative articles were synthesized using integrative review strategies. Synthesis: Three key gaps were identifed in the literature: variations in the calculation of hyperglycemia prevalence and in the measurement of hyperglycemia, as well as inconsistent use of standard guidelines. Conclusions: This review highlights the inconsistencies in measuring or assessing hyperglycemia and the lack of standardized guidelines in treating hyperglycemia. Failure to have a standard approach to the measurement and management of hyperglycemia impedes the ability of healthcare providers to determine the signifcance of its impact on health outcomes. Further research is needed to establish appropriate measurement guidelines to address hyperglycemia in people with cancer. Implications for Practice: Evidence-based measurement and treatment guidelines are needed to inform and assist healthcare providers with clinical decision making for people with cancer who experience hyperglycemia.