NPPB and cancer: Based on our findings, we propose a risk-adapted monitoring protocol for diabetic cancer patients receiving anthracyclines or other high-risk therapies: (1) Baseline ECG and cardiac biomarkers (NT-proBNP, troponin I); (2) Serial ECG and biomarker assessments before/after each treatment cycle; (3) Thresholds for intervention (e.g., cardiology referral) if NT-proBNP rises ≥50% or troponin I exceeds 5 ng/L.