DISCUSSION
cancer, comorbidity, T2D, diabetes
CANCER, DIABETES
This pilot study was closed due to failing feasibility metrics. The largest barrier was identifying eligible patients with POC HbA1c determinations. One way to improve identification of future patients would be to integrate HbA1c testing into order sets for all newly diagnosed cancer patients entering the clinic and broaden the eligibility criteria to a more pragmatic assessment of clinical acceptability for metformin use, rather than only including those with laboratory values within normal limits. This area of research is important because undiagnosed diabetes prior to cancer diagnosis may deteriorate blood glucose level and cause poor prognosis due to difficulty of co‐managing both comorbidity and low healthcare provider contact.Some patients have difficulty prioritizing primary care while undergoing cancer treatment and PCPs may also defer treatment of chronic conditions during this time.A limitation of this study was the small number of eligible patients. While many patients were agreeable to participate, the time needed to screen patients for T2D using POC HbA1c testing was inefficient. Participation may have been affected by the time and burden of a fingerstick blood sample within their first oncology visit. This study was also conducted during the COVID‐19 pandemic which may have had a negative effect on participation. Due to low enrollment, we were unable to make conclusions regarding the HbA1c levels, diabetes self‐management, or participant acceptability of the study.This study was strengthened by the large collaborative, interdisciplinary team. Another strength of this study was T2D screening within their first oncology visit and rapid access to T2D education, glucometer, and treatment with metformin for patients newly diagnosed with cancer without having to coordinate care with their primary providers. In an effort to improve the noted inefficiencies and enrollment, it is recommended that future researchers include HbA1c testing with existing order sets for all newly diagnosed cancer patients entering the clinic and consider assessing and expanding eligibility criteria as appropriate. Also, decreased access to health care is associated with undiagnosed T2D, uncontrolled T2D, and cancer diagnosed at an advanced stage so it is imperative that underserved populations at increased risk of experiencing challenges accessing health care are included in future studies.