Dietary Management for Patients with Diabetes Mellitus Undergoing Chemotherapy

Managing hyperglycemia during chemotherapy is challenging due to the metabolic shift caused by such treatments and the risk of malnutrition. This study aims to review the metabolic changes in these patients and propose effective nutritional strategies. Based on ESPEN (The European Society for Clinical Nutrition and Metabolism) guidelines and recent clinical studies, this paper analyzes the impact of chemotherapeutic agents (e.g., glucocorticoids, mTOR inhibitors) on glucose metabolism and discusses optimal intake levels for macronutrients and micronutrients. Nutritional priorities should focus on preventing malnutrition rather than overly strict glycemic control, which may cause hypoglycemia. Key recommendations include an energy intake of 25~30 kcal/kg/day and protein intake of 1.0~1.5 g/kg/day (up to 2.0 g/kg/day). Increasing the fat-to-carbohydrate ratio may be beneficial for patients with insulin resistance to improve energy density. Nutritional therapy for cancer patients with diabetes is a critical component of oncologic care that enhances treatment tolerance as well as survival. Personalized nutritional assessment and timely intervention are essential to balance glycemic control with optimal nutritional status.