Table 4 Cases of Immune Checkpoint Inhibitors Induced Diabetes Mellitus

Reports

55

Cases

66

Gender

Males = 42; Females = 24

Age (years)

Median = 63.5; Mean ± SD = 62 ± 13.2; Range = 28–84

Pertinent medical history

PHx diabetes: Reported = 36; Not reported = 30

FHx diabetes: Reported 27; Not reported = 39

Hx AutoD: Reported = 15; Not reported = 51

Type of cancer (all metastatic)

Melanoma = 30; Non-small cell lung cancer = 10; Renal cell carcinoma = 7; Lung cancer = 11; Urothelial carcinoma = 2, Small cell jaw cancer = 1, Small cell tonsillar cancer = 1; Small cell maxillary sinus cancer = 1; Hodgkin’s lymphoma = 1, Cholangiocarcinoma = 1, Not reported = 1

Check point inhibitor

Drug D/C?:

Pembro = 13; Nivo = 32; Nivo + Ipi = 6; Pembro + Ipi = 1; Ipi, then Pembro = 5;

Ipi, then Nivo = 3; Avelu + Utomi = 1; Atezo = 2; Unnamed PDL-1 = 2; Ipi = 1

Yes = 22, No = 15, Ipi stopped/Pembro continued = 1, Not reported = 28

Clinical presentation

DKA = 43; Hyperglycemia = 20; Not reported = 3

Onset (weeks) after first dose

Median = 7, Mean ± SD = 11.7 ± 11.7 Range 1–52

Biochemical tests

↑Glucose = 57; ↑A1c = 49; ↑β-OHB = 10

↓pH = 35; ↓C-pep = 48

Antibody evaluation

Any antibodies (GAD65, IA2, ZnT8, IAA) positive = 34 (51.5%)

Antibodies negative = 27 (41%)

Antibodies not reported = 5 (7.5%)

Pancreatic imaging

CT with ↓ volume or atrophy = 3, CT with pancreatitis = 1; MRI with diffuse inflammation = 1

CTCAE severity grade reported

Yes = 4; Not reported = 62

Therapy at onset at diagnosis in addition to insulin

Metformin =1, Glimepiride = 1,glyburide = 1; Diet = 2, High dose steroids* = 10

Outcome

Remained insulin-dependent = 52, Recovered = 1,

Not reported = 13