Systematic review of the risk of type 2 diabetes post therapy for early-stage breast cancer

Aims: The purpose of this systematic review was to examine the risk of developing type 2 diabetes in cancer survivors undergoing adjuvant therapy and to collate and appraise the available evidence to provide clinicians with additional evidence to consider when choosing treatments for breast cancer patients. Methods: MEDLINE, PubMed, EMBASE, and Scopus databases were searched. Articles describing the effects of adjuvant chemotherapy or endocrine therapy and how the treatments affected glucose and/or insulin resistance in women aged 18 years or older with breast cancer were included for analysis. Results: Nine publications were included in this systematic review. No association was found between adjuvant chemotherapy and the use of aromatase inhibitors on the development of type 2 diabetes. In three out of five studies, long-term tamoxifen use was associated with an increased risk of developing type 2 diabetes. Conclusion: There is some indication that long-term tamoxifen use is associated with an increased risk of developing type 2 diabetes in breast cancer patients. However, all studies were observational in nature. Further studies are needed to conclusively establish the relationship between this class of medication, treatment length, and the risk of type 2 diabetes in breast cancer survivors.