CASE REPORT article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1589630
This article is part of the Research TopicEndocrine Diseases Related to Immune Checkpoint InhibitorsView all articles
Immune checkpoint inhibitor-associated diabetes mellitus: The case series report
Provisionally accepted
- 1First Affiliated Hospital of Anhui Medical University, Hefei, China
- 2Fuyang Tumor Hospital, Fuyang, Jiangsu Province, China
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This report aims to better define the rare adverse event of immune checkpoint inhibitor-associated diabetes mellitus(ICI-DM). We present 10 cases of patients including six of the patients had no prior history of diabetes, while four had varying degrees of pre-existing diabetes. Eight who received anti-PD-1 combination therapy, one who received anti-PD-1 monotherapy, and one who received dual anti-PD-1/CTLA-4 therapy. The mean time from initiation of immunotherapy to the onset of ICI-DM was 245.4 days (median, 149 days; range, 11 to 787 days). Diabetic ketoacidosis (DKA) occurred in 60% (6/10) of the patients, with a median fasting blood glucose level of 25.85 mmol/L (range, 14.76 to 38.23 mmol/L), and all had C-peptide levels below the normal range. Through a retrospective analysis of the clinical data of these 10 patients, we found that monitoring fasting blood glucose and HbA1c is crucial for patients undergoing or having undergone immunotherapy, as rapid pancreatic β-cell destruction can be observed in those who develop ICI-DM, potentially due to disruption of the PD-1/PD-L1 pathway.
Keywords: Immune checkpoint inhibitor, Diabetes Mellitus, Immune-associated diabetes mellitus, adverse events, clinical manifestations
Received: 10 Mar 2025; Accepted: 18 Jun 2025.
Copyright: © 2025 Ma, Xue, Cheng, Hesheng and Du. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Qian Hesheng, Fuyang Tumor Hospital, Fuyang, 236061, Jiangsu Province, China
Yingying Du, First Affiliated Hospital of Anhui Medical University, Hefei, China
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