| Learning Objective #1: understand the sensory, motor and autonomic effectson peripheral nerve function that can result from diabetes and cancer treatment. | |||
| Learning Objective #2: describe the trajectory of changes in peripheral nerve function that occur in conjunction with neurotoxic chemotherapy administration over time. |
Cancer remains a challenging problem for elders, as both cancer and comorbid conditions are common in this age group, and can result in increased morbidity from toxicities associated with cancer treatments. The interaction of comorbid conditions and cancer treatment remains largely unquantified. Diabetics may be most at risk for the additive effects of neurotoxic agents, in addition to the effects induced by the chemotherapeutic agents alone.
A physiologic framework of drug and diabetes-induced neuronal degeneration was used for this pilot study.
The purposes of this prospective, longitudinal study are to determine the change in peripheral nerve function of diabetics occurring during and after treatment with neurotoxic taxane or platinum-containing chemotherapy regimens, and to determine the extent to which level of glycemic control predicts a differential pattern in outcome beyond the effect of chemotherapy.
A convenience sample of 14 participants with diabetes and newly diagnosed solid tumor cancer receiving treatment with taxane and/or platinum-containing regimens were recruited. The outcome measures assessed are: cutaneous sensation, vibration, orthostatic blood pressure, gait, balance, and glycemic control. Data was collected at baseline, at every cycle of chemotherapy (4 cycles) and two months after completion of treatment.
Descriptive statistics was used to describe the peripheral nerve function. Data were analyzed using regressions slopes to determine change in the dependent variables over time. Cutaneous sensation, blood pressure, gait, and balance remain stable, while lower extremity vibration sense declines (14%) over the study period. Study participants exhibit poor glycemic control over the study period.
Consistent, comprehensive measurement of progressive neuropathy in older diabetics will generate data useful in designing nursing interventions to reduce the impact of peripheral neuropathy on safety, activities of daily living, and quality of life. Knowledge about the effects of comorbidities and cancer treatment can assist in optimum treatment for debilitating neuropathies.
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See more of The 17th International Nursing Research Congress Focusing on Evidence-Based Practice (19-22 July 2006)