<b>OBJECTIVE</b>
<p>To characterize immune checkpoint inhibitor-associated diabetes
mellitus (ICI-DM) in a single-institution case series. </p>
<p><b>DESIGN AND METHODS</b></p>
<p>Retrospective
chart review of 18 patients with new-onset ICI-DM following anti-PD-1/anti-PD-L1
therapy for advanced carcinomas.</p>
<p><b>RESULTS</b></p>
<p>9/18 patients had diabetic ketoacidosis (median glucose: 27.92mmol/L;
median glucose before presentation: 6.35mmol/L). Median C-peptide at ICI-DM
diagnosis was low, and declined during follow-up. Median anti-PD-1/anti-PD-L1
duration before ICI-DM was 3.65
months (range 0.56-12.23).
Time to ICI-DM onset was a
median 1.4 months/3 ICI cycles and 6 months/10
cycles in those positive and negative for GAD65 autoantibodies, respectively. Time to ICI-DM onset was a median 2.5 months/3 ICI cycles and 4.8
months/8 cycles after anti-PD-L1 or anti-PD-1 therapy, respectively. Significant
pancreatic atrophy was seen radiographically.</p>
<p><b>CONCLUSIONS</b></p>
<p>ICI-DM presents abruptly, appears irreversible, is characterized
by pancreatic atrophy, and may <a>occur both earlier following
PD-L1 blockade compared to PD-1 inhibition </a>and in those who have positive
GAD65 autoantibodies.</p>
Immune Checkpoint Inhibitor-Associated Diabetes Mellitus: A Single-Institution Experience
