Slow Accrual

The purpose of this study is to test a nurse-led intervention for adults with newly diagnosed cancer and undiagnosed/newly diagnosed Type-2 diabetes

Specific Aim 1: To examine study feasibility of a nurse-led intervention for adults with newly diagnosed cancer and T2D. We define feasibility indicators as: (a) efficient study recruitment is possible given prevalence of T2D (diagnosed and undiagnosed) in UF patients with newly diagnosed cancer; (b) retention rates in both groups ≥80% to indicate that the study design and methods are adequately patient-centered; (c) identified barriers to and facilitators of a nurse-led intervention are respectively modifiable or optimizable; and (d) patient acceptability scores >8 for the study procedures. We hypothesize that we will recruit up to 40 patients within 18 months and retain ≥ 80% of patients in all groups; minor but important revisions will be required to resolve issues identified with using the nurse-led intervention; and 80% of patients from both groups who complete the study will report that the burden of the study is acceptable through their retention in the study.

Specific Aim 2: To determine the variation in HbA1c at baseline and at the end of the three-month intervention period in each of the two study groups.

Inclusion Criteria:

• a) 18 years and older
• b) Using pathology reports, a new diagnosis of a solid tumor cancer or lymphoma within the past 3 months
• c) Patients being treated with curative intent or those with a prognosis estimated to be >2 years, as best assessed by the oncologist.
• d) First medical oncology outpatient visit at UF within the past 3 months
• e) Plans to continue cancer care at UF
• f) Speaks and reads English
• g) Can comply with study related procedures, per the treating oncologist or advanced practice provider

Exclusion Criteria:

• a) Diagnosis of leukemia or pancreatic cancer as the new cancer diagnosis
• b) Being treated for T2D for > than 3 months
• c) eGFR <45mL/minute/1.73m2
• d) Liver insufficiency (defined as liver enzymes over 5 times the upper limit of normal or clinical sequelae of advanced cirrhosis as documented by the treating oncologist or Advanced Practice Providers.
• e) Active infection requiring systemic antibiotics
• f) Taking systemic steroids of more than 1-week duration. Must have stopped >3 days prior to study enrollment. Note, inhaled or topical steroids are not exclusion criteria.
• g) Planning to receive cancer care at a location outside of UF
• h) Enrolled in another study with similar outcomes.
• i) Currently taking metformin or known inability to tolerate it