Unraveling the Nexus of Glioblastoma Multiforme and Type II Diabetes Mellitus in a Long-term Survivor - A Unique Case Study

This case study explores the intricate relationship between Glioblastoma Multiforme (GBM) and Type II Diabetes Mellitus (T2DM) in a long-term survivor. A 51-year-old male with a medical history of type II diabetes presented with black out episodes. Neuroimaging revealed a large right frontal lesion suggestive of GBM. Following gross total resection, the tumor was identified as IDH-wildtype, MGMT methylated glioblastoma. The patient underwent Stupp protocol chemotherapy with Temozolomide and radiation, followed by adjuvant therapy. Management also included adjustments to diabetic medications. The patient experienced mild abulia and decreased executive function post-chemotherapy but responded well to subsequent treatments, including Avastin. Medication adjustments for diabetes were made based on A1C and glucose levels. Imaging studies revealed changes indicative of treatment response and disease progression. Correlation analyses revealed negative associations between resection cavity and affected brain tissue volume and glucose/A1C levels. The study underscores the importance of exploring the impact of antidiabetic medications on GBM outcomes and highlights the need for further research in this area. Lessons learned include the potential role of metabolic biomarkers in predicting treatment response and disease progression, guiding personalized therapeutic interventions for patients with comorbid GBM and T2DM.