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Background <p>Managing diabetes in patients with cancer requires balancing oncologic priorities with safe glycemic targets. Evidence describing how trainees from different specialties approach this interface is limited.</p> Methods <p>We conducted a cross-sectional pilot survey among 111 physicians (Internal Medicine <i>n</i> = 50; Endocrinology <i>n</i> = 19; Medical Oncology <i>n</i> = 42). The questionnaire comprised four knowledge (T/F), eight perception, and four attitude items. Scores were computed as total knowledge (0–4), perception (0–32), and a composite attitude score (6–14) formed by summing the treatment attitude subscale (0–12) and the steroid attitude item (0–4) after harmonizing item directions. Non-parametric tests compared groups; associations used Spearman’s rho and ordinal/linear regression. Reliability was assessed with Cronbach’s alpha.</p> Results <p>Median knowledge, perception, and composite attitude scores were 2, 18, and 11, respectively; no overall differences were observed across specialties. Perception items differed for the cardiovascular impact of poor glycemic control in patients with short life expectancy (<i>p</i> = 0.037), the safety of short-term steroids in advanced disease (<i>p</i> = 0.0017), and the potential harm of steroids with immunotherapy (<i>p</i> = 0.048). Avoidance of steroids in patients with uncontrolled glycemia differed by specialty (<i>p</i> = 0.0014). Correlations showed knowledge modestly associated with perception (ρ = 0.348) and attitude (ρ = 0.212), while perception more strongly associated with attitude (ρ = 0.437). In multivariable models, each 1-point increase in knowledge independently predicted preference for metformin as first choice and for strict control in metastatic disease, and—together with perception—predicted avoidance of steroids; perception also predicted avoidance of aggressive control in limited life expectancy. Cronbach’s α was 0.77 overall and 0.76 for the treatment subscale.</p> Conclusions <p>Knowledge levels were broadly comparable across specialties, but perceptions and attitudes diverged, especially regarding steroids and end-of-life glycemic intensity, highlighting a need for interdisciplinary education and consensus to harmonize onco-diabetology practice.</p>

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Knowledge, perceptions and attitudes toward diabetes care in oncology: a pilot survey across specialties (DiaLog Study)

  • 期刊论文

  • 发表日期：

    2026年2月3日

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  • Guler Nur Tekustun,
  • Besra Hazal Yesil-Gurel,
  • Sait Kitapli,
  • Ali Alkan,
  • Ozgur Tanriverdi

摘要

Background

Managing diabetes in patients with cancer requires balancing oncologic priorities with safe glycemic targets. Evidence describing how trainees from different specialties approach this interface is limited.

Methods

We conducted a cross-sectional pilot survey among 111 physicians (Internal Medicine n = 50; Endocrinology n = 19; Medical Oncology n = 42). The questionnaire comprised four knowledge (T/F), eight perception, and four attitude items. Scores were computed as total knowledge (0–4), perception (0–32), and a composite attitude score (6–14) formed by summing the treatment attitude subscale (0–12) and the steroid attitude item (0–4) after harmonizing item directions. Non-parametric tests compared groups; associations used Spearman’s rho and ordinal/linear regression. Reliability was assessed with Cronbach’s alpha.

Results

Median knowledge, perception, and composite attitude scores were 2, 18, and 11, respectively; no overall differences were observed across specialties. Perception items differed for the cardiovascular impact of poor glycemic control in patients with short life expectancy (p = 0.037), the safety of short-term steroids in advanced disease (p = 0.0017), and the potential harm of steroids with immunotherapy (p = 0.048). Avoidance of steroids in patients with uncontrolled glycemia differed by specialty (p = 0.0014). Correlations showed knowledge modestly associated with perception (ρ = 0.348) and attitude (ρ = 0.212), while perception more strongly associated with attitude (ρ = 0.437). In multivariable models, each 1-point increase in knowledge independently predicted preference for metformin as first choice and for strict control in metastatic disease, and—together with perception—predicted avoidance of steroids; perception also predicted avoidance of aggressive control in limited life expectancy. Cronbach’s α was 0.77 overall and 0.76 for the treatment subscale.

Conclusions

Knowledge levels were broadly comparable across specialties, but perceptions and attitudes diverged, especially regarding steroids and end-of-life glycemic intensity, highlighting a need for interdisciplinary education and consensus to harmonize onco-diabetology practice.