Body mass index is related to short term retinal worsening in type 2 diabetes patients treated with anticancer drugs

Background: In cancer patients with diabetes, anticancer drugs (ADs) may negatively affect the course of diabetes vascular complications. The short-term effects of ADs on type 2 diabetes (T2D) retinopathy are poorly known. This study evaluated the short-term effects of different classes of ADs on diabetic retinopathy (DR) and clinical risk factors for retinal worsening (RW) in cancer patients affected by T2D. Methods: Retrospective single-centre study evaluating 168 patients with T2D and cancer. The diagnosis of T2D preceded those of cancer in all patients. We evaluated the retinal short-term effects within the six months after the first-line ADs treatment. Results: After ADs, 6% of patients had a short-term RW. BMI is positively associated with the risk of RW (OR 1.45, 95% confidence interval (CI) 1.1-1.9, p<0.005). Patients treated with alkylating agents and topoisomerase inhibitors have an increased risk of RW (p=0.049 and p=0.057, respectively) and a significantly higher HDL level (p<0.01). Conclusions: To our knowledge, this study is the first investigating the short-term impact of ADs on DR of T2D patients. Moreover, we provide information arose from a real-world setting. As confirmed by other studies, these findings could help to identify patients at risk for shortterm RW, who should be promptly referred to the ophthalmologist for the prevention of visual impairment.