Speaker
Description
PURPOSE: Insulin resistance (IR) and hyperglycemia are common side effects of cancer therapy, and IR that persists despite treatment cessation is likely much more common than previously estimated. It is unclear if habitual physical activity (PA) alters cancer-induced IR in the year after diagnosis. METHODS: Fasting glucose, insulin, and self-reported PA were measured at diagnosis, 6-, and 12-months post-diagnosis in n=73 stage I-III breast cancer patients who received chemotherapy. IR was assessed via Homeostasis Model Assessment-Insulin Resistance (HOMA-IR). Differences in HOMA-IR, hormones and metabolites by PA were quantified via ANOVA, and associations between variables over time were determined via logistic regression. Participants were then placed into quartiles based on individual percent change in HOMA-IR from diagnosis-6M and 6M-12M to determine any contribution of PA to the attenuation and/or reversal of IR. RESULTS: Compared to active patients (n=37), inactive patients (n=36) had significantly elevated HOMA-IR (3.1±2.8 vs. 2.0±1.6, p<0.01) and glucose (5.3±0.7 vs. 4.8±0.7 mmol, p<0.001) at diagnosis. Among patients who were active at diagnosis, those who temporarily reduced or halted PA at 6M had higher HOMA-IR at 12M compared to those who consistently maintained (or increased) PA levels (1.8±1.2 vs. 1.2±0.7, p<0.05). Glucose concentrations at 12M were lower in patients who initiated PA at 6- and/or 12M compared to patients who remained inactive (5.0±0.5 vs. 5.6±1.1 mmol, p<0.04) despite no difference in HOMA-IR. PA did not significantly contribute to the attenuation or reversal of cancer-induced IR, however over 60% of those patients with the greatest percent reduction in IR also increased PA intensity from 6- to 12M. CONCLUSION: PA is beneficial for glycemic control regardless of activity levels at diagnosis, but high levels of PA alone may not prevent cancer-induced IR. Increasing PA intensity may contribute to reversal of IR, but more precise assessments of PA and IR is required.
Keywords
Survivorship, Cardiometabolic Health, Exercise, Diabetes
| Abstract submitters declaration | yes |
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| Conflict of Interest & Ethical Approval | yes |
