Postoperative fatigue trajectories among pancreatic tumor survivors with diabetes: The role of glycemic control.

PURPOSE: The purpose of this study was to describe the fatigue trajectories in operable pancreatic tumor survivors with diabetes by glycemic control (i.e., HbA1c ≤ 7% or > 7%) and identify the determinants of the fatigue trajectories for the two glycemic control groups.

METHODS

A longitudinal study was conducted among 99 survivors of operable pancreatic tumors with diabetes from a pancreatic surgical outpatient department at a medical center. Fatigue was measured using the Fatigue Symptom Inventory at five time points over 12 months. HbA1c and potential factors (i.e., performance status, body mass index [BMI], depression, diabetes distress, and social support) were assessed at baseline. The fatigue trajectory and its predictors were analyzed using generalized estimating equations.

RESULTS

Survivors with baseline HbA1c ≤ 7% experienced increasing fatigue trajectories over time. In contrast, among survivors with baseline HbA1c > 7%, although an overall decreasing trend in fatigue was observed over 12 months, fatigue levels increased at 6 months post-baseline. Modifiable factors, including BMI, depression, and diabetes distress, were associated with fatigue among survivors with baseline HbA1c ≤ 7%, whereas performance status and social support were related to fatigue among survivors with baseline HbA1c > 7%.

CONCLUSION

Operable pancreatic tumor survivors with diabetes experience distinct fatigue trajectories and associated predictors according to glycemic control status, highlighting distinct fatigue-related care needs across glycemic control groups. Nurses are advised to incorporate strategies tailored to glycemic control status to more effectively address fatigue and improve overall well-being among operable pancreatic tumor survivors with diabetes.