Health Questions and Answers

Question: How does cancer affect carbohydrate metabolism?


Tumor-bearing patients develop changes in carbohydrate metabolism. These patients have elements in common with both type II diabetes and stress. Cancer patients will develop a 25-40% increase in hepatic glucose production, similar to that seen in diabeteic patients. But diabeteic patients will decrease hepatic glucose production during starvation, while cancer patients will increase glucose production. This may be due to an increased availabilty of precursors of gluconeogenesis such as alanine, glycerol, and lactate. Increased circulating lactate, found in cancer patients, is used by the liver to make glucose for both the tumor and the host. Early in their course cancer patients demonstrate this as glucose intolerance. They have hyperglycemia and delayed clearance of both intravenous and oral glucose. Insulin resistance has been shown to be a major cause of this glucose intolerance. Cancer patients demonstrate an increased total body turnover of glucose, which according to Shaw and Wolfe, is proportional to the extent of disease. They show increased Cori cycle activity- increased recycling of carbon fragments derived from glucose.

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