Malignant tumors and diabetes mellitus have gradually become the most common chronic non-communicable diseases in China. They are closely related. The risk

mortality and adverse prognosis of various malignant tumors in diabetic patients are significantly increased. Hyperglycemia in cancer patients is very common. From the aspect of etiology

some malignant tumors lead to hyperglycemia and/or diabetes

and hyperglycemia and/or diabetes can occur during the treatment of malignant tumors

including surgical stress

chemotherapeutic drugs

radiotherapy

glucocorticoids

a variety of targeted drugs and the application of immune checkpoint inhibitors

which is collectively referred to as tumor-associated hyperglycemia. Tumor-associated hyperglycemia is difficult to manage in clinical practice

and the quality of blood glucose control is closely related to the risk and adverse prognosis of patients with malignant tumor. However

there is currently no relevant guideline for the clinical diagnosis and management. Therefore

standardized management of malignant tumor-associated hyperglycemia is necessary. In view of this

the Onco- endocrinology Society of Chinese Anti-Cancer Association and Onco-endocrinology Society of Chong Qing Integrative Medicine Association have drafted Guidelines for the Management of Tumor-associated Hyperglycemia (2021 Edition)

a comprehensive report based on the opinions of many domestic experts in oncology and endocrinology. In addition to summarizing the relationship between diabetes and multiple malignant tumors

the guidelines include the etiology of tumor-associated hyperglycemia/diabetes

the epidemiology of tumor-associated hyperglycemia

the concept of tumor-associated hyperglycemia

the diagnostic and differential diagnostic criteria and the standardized management of tumor-associated hyperglycemia

including the overall assessment methods and principles of tumor-associated hyperglycemia

individualized control objectives

management during clinical hospitalization (preadmission preparation

blood glucose management during hospitalization

insulin therapy

intensive care unit and non-intensive care unit management

ketoacidosis and hyperosmolar hyperglycemia

hypoglycemia treatment

perioperative blood glucose management

blood glucose management during enteral/parenteral nutrition

pregnancy with hyperglycemia or diabetes management

glucocorticoid application management

hospice care

transition from inpatient to outpatient

medication precautions

predischarge treatment

etc.)

the impact of a variety of hypoglycemic drugs on malignant tumors

the impact of tumor therapeutic drugs on blood glucose and outpatient management

including the establishment of archives of patients with malignant tumors

health examination of blood glucose and complications

long-term follow-up and evaluation. In addition

combined with the actual medical situation in China

the guidelines provide two-way referral and graded diagnosis and treatment for patients with tumor-associated hyperglycemia and put forward relevant suggestions and standards to facilitate the convenient implementation of medical institutions and medical personnel at all levels. The guidelines put forward the corresponding classification of recommendations according to the principle of evidence-based medical evidence classification

which will help clinicians to rationalize and standardize the management of patients with tumor-associated hyperglycemia

so as to improve their clinical outcome and prognosis. Here

we made an interpretation of the contents and recommendations.