PMID- 35991054
OWN - NLM
STAT- MEDLINE
DCOM- 20220823
LR  - 20220829
IS  - 2296-2565 (Electronic)
IS  - 2296-2565 (Linking)
VI  - 10
DP  - 2022
TI  - PD-1 inhibitor-associated type 1 diabetes: A case report and systematic review.
PG  - 885001
LID - 10.3389/fpubh.2022.885001 [doi]
LID - 885001
AB  - OBJECTIVE: This study aimed to summarize the clinical characteristics of 
      programmed death receptor 1 (PD-1) inhibitor-associated type 1 diabetes so as to 
      improve the ability of clinicians to correctly diagnose and treat it. METHODS: We 
      reported a case of a 70-year-old woman with gastric cancer who developed 
      hyperosmolar hyperglycemic coma during camrelizumab (a PD-1 inhibitor) treatment 
      and was diagnosed with PD-1 inhibitor-associated type 1 diabetes. We conducted a 
      systematic review of 74 case reports of type 1 diabetes associated with PD-1 
      inhibitor therapy published before June 2022. RESULTS: The patient developed type 
      1 diabetes with hyperosmolar hyperglycemic coma after receiving camrelizumab 
      chemotherapy for 6 months (9 cycles). We searched 69 English articles comprising 
      75 patients, all of whom had been treated with a PD-1 inhibitor (nivolumab or 
      pembrolizumab) and progressed to diabetes after an average of 6.11 (1-28) cycles. 
      Nivolumab combined with ipilimumab (a cytotoxic T lymphocyte-associated protein 4 
      inhibitor) had the shortest onset (4.47 cycles on average). A total of 76% 
      (57/75) of patients developed diabetic ketoacidosis (DKA) at onset, and 50.67% 
      (38/75) of patients had C-peptide <0.1 ng/mL. Most of the patients were tested 
      for insulin autoantibodies, with a positive rate of 33.33% (23/69); of these, 
      86.96% (20/23) were tested for glutamate decarboxylase antibody and 46.67% 
      (35/75) were tested for human leukocyte antigen (HLA). HLA-DR4 was the most 
      common type. CONCLUSIONS: The progression of type 1 diabetes induced by PD-1 
      inhibitors is relatively rapid. Islet failure often occurs when detected, 
      seriously endangering patients' lives. Patients treated with PD-1 inhibitors 
      should closely monitor their plasma glucose level during treatment to detect, 
      diagnose, and treat diabetes on time.
CI  - Copyright (c) 2022 Lin, Li, Qiu, Chen and Liu.
FAU - Lin, Cuiping
AU  - Lin C
AD  - Department of Endocrinology and Metabolism, Second Affiliated Hospital of 
      Nanchang University, Nanchang, China.
FAU - Li, Xuan
AU  - Li X
AD  - Department of Endocrinology and Metabolism, Second Affiliated Hospital of 
      Nanchang University, Nanchang, China.
FAU - Qiu, Yu
AU  - Qiu Y
AD  - Department of Endocrinology and Metabolism, Second Affiliated Hospital of 
      Nanchang University, Nanchang, China.
FAU - Chen, Zheng
AU  - Chen Z
AD  - Department of Endocrinology and Metabolism, Second Affiliated Hospital of 
      Nanchang University, Nanchang, China.
FAU - Liu, Jianping
AU  - Liu J
AD  - Department of Endocrinology and Metabolism, Second Affiliated Hospital of 
      Nanchang University, Nanchang, China.
LA  - eng
PT  - Case Reports
PT  - Systematic Review
DEP - 20220805
PL  - Switzerland
TA  - Front Public Health
JT  - Frontiers in public health
JID - 101616579
RN  - 0 (Immune Checkpoint Inhibitors)
RN  - 31YO63LBSN (Nivolumab)
SB  - IM
MH  - Aged
MH  - Coma/chemically induced
MH  - *Diabetes Mellitus, Type 1/chemically induced/diagnosis
MH  - Female
MH  - Humans
MH  - Immune Checkpoint Inhibitors
MH  - *Nivolumab/adverse effects
PMC - PMC9389003
OTO - NOTNLM
OT  - PD-1 inhibitors
OT  - camrelizumab
OT  - diabetes
OT  - immune checkpoint inhibitor
OT  - insulin
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/08/23 06:00
MHDA- 2022/08/24 06:00
PMCR- 2022/08/05
CRDT- 2022/08/22 04:05
PHST- 2022/04/22 00:00 [received]
PHST- 2022/07/22 00:00 [accepted]
PHST- 2022/08/22 04:05 [entrez]
PHST- 2022/08/23 06:00 [pubmed]
PHST- 2022/08/24 06:00 [medline]
PHST- 2022/08/05 00:00 [pmc-release]
AID - 10.3389/fpubh.2022.885001 [doi]
PST - epublish
SO  - Front Public Health. 2022 Aug 5;10:885001. doi: 10.3389/fpubh.2022.885001. 
      eCollection 2022.