Sudden onset type 1 diabetes mellitus induced by immune checkpoint inhibitors in the treatment of advanced cancer. Cases report

Authors

  • Arturo López Rivera San Carlos Sanatorium, Río Negro, Argentina
  • Diego Carulla San Carlos Sanatorium, Río Negro, Argentina
  • Adolfo Capó Regional Integration Oncology Center (COIR), Mendoza, Argentina
  • Martín Rodríguez Institute of Medical Clinic and Diabetes, Mendoza, Argentina

DOI:

https://doi.org/10.47196/diab.v57i2.628

Keywords:

type 1 diabetes mellitus, diabetic ketoacidosis, immune checkpoint inhibitors

Abstract

Three patients with advanced cancer, treated with inmune checkpoint inhibitors (ICIs), with no history of diabetes mellitus (DM), were admitted to the Emergency Department with polyuria, polydipsia, and weight loss and a diagnosis of diabetic ketoacidosis without clinical evidence of infection. They were treated with fluids and insulin infusion transitioning to a basal-bolus insulin regimen, which continued after discharge. Autoantibody detection tests for DM were negative and they were diagnosed with DM induced by ICIs, pembrolizumab in two of them, and nivolumab in another. The purpose of this case report is to show the development of DM1 in an acute form in patients treated with PD-1 inhibitors. Based on these cases and the reviewed literature, we seek to identify clinical characteristics and suggest strategies for the proper identification, control, treatment, and follow-up of patients treated with ICIs to minimize the impact of autoimmune dysfunction.

Author Biographies

Arturo López Rivera, San Carlos Sanatorium, Río Negro, Argentina

Internal Medicine Specialist and Master in Diabetes, Head of the Diabetes and Nutrition Service

Diego Carulla, San Carlos Sanatorium, Río Negro, Argentina

Specialist in General Medicine and Master in Diabetes, Staff Physician of the Diabetes and Nutrition Service

Adolfo Capó, Regional Integration Oncology Center (COIR), Mendoza, Argentina

Head of the Provincial Oncology Program, Project Coordinator

Martín Rodríguez, Institute of Medical Clinic and Diabetes, Mendoza, Argentina

Specialist in Internal Medicine, Nutrition and Diabetes, Area of Endocrinology, Metabolism and Nutrition, Faculty of Medical Sciences, National University of Cuyo (UNCuyo)

References

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Published

2023-06-26

How to Cite

López Rivera, A., Carulla, D., Capó, A., & Rodríguez, M. (2023). Sudden onset type 1 diabetes mellitus induced by immune checkpoint inhibitors in the treatment of advanced cancer. Cases report. Journal of the Argentine Society of Diabetes, 57(2), 105–108. https://doi.org/10.47196/diab.v57i2.628

Issue

Section

Clinical cases

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