Journal: Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association
This review provides a detailed analysis of managing type 2 diabetes (T2D) in gastric cancer (GC) patients throughout the surgical timeline: preoperative, intraoperative, and postoperative phases, within oncodiabetology.
Preoperative phase:
- Predicting T2D remission is essential.
- Careful selection of antidiabetic medications such as metformin and SGLT2 inhibitors is important, as these may also help to impede cancer progression.
Intraoperative phase:
- Roux-en-Y reconstruction demonstrates better T2D remission compared to Billroth I/II, likely due to improved glucose metabolism.
- The emerging concept of oncometabolic surgery combines cancer treatment with metabolic benefits to optimize outcomes.
Postoperative phase:
- Vigilant glucose monitoring is critical.
- Tailored medication management, weight control, and patient education help sustain remission and prevent relapse.
Overall, a phase-specific, integrated glycemic care approach enhances both metabolic and oncologic outcomes in GC patients.