Diabetes, Metabolic Syndrome and Obesity (Nov 2018)
TNM cancer staging: can it help develop a novel staging system for type 2 diabetes?
Abstract
Moahad S Dar,1,2 Sami A Bég3 1Department of Veteran Affairs, Greenville Health Care Center, Greenville, NC, USA; 2Division of Endocrinology & Metabolism, Department of Internal Medicine, Brody School of Medicine at East Carolina University, Greenville, NC, USA; 3Proactive Living Inc., Columbia, SC, USA Abstract: Type 2 diabetes (DM2) constitutes 90%–95% of the diabetes cases and is increasing at an alarming rate in the world. The Centers for Disease Control and Prevention (CDC) estimates that more than 29 million people in the United States have diabetes, which often causes mortality from macrovascular complications and morbidity from microvascular complications. Despite these troubling facts, there is currently no widely accepted staging system for DM2 like there is for cancer. TNM oncologic staging has taken a complex condition like cancer and conveyed likelihood of survival in simple alpha-numeric terms that both patients and providers can understand. Oncology is now entering the era of precision medicine where cancer treatment is increasingly being tailored to each patient’s cancer. In contrast, DM2 lacks a staging system and remains a largely invisible disease even though it kills more Americans and costs more to treat than cancer. Is a comparable staging system for DM2 possible? We propose the Diabetes Staging System for DM2 that utilizes macrovascular events, microvascular complications, estimated glomerular filtration rate (GFR), and hemoglobin A1C to stage DM2. Keywords: type 2 diabetes, macrovascular complications, microvascular complications, hemoglobin A1C, glomerular filtration rate, GFR, TNM cancer staging
