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免疫疗法诱导的1型糖尿病的管理。

Management of Immunotherapy-Induced Type 1 Diabetes.

作者信息

Brady Veronica

机构信息

Department of Research, University of Texas Health- Cizik School of Nursing, 6901 Bertner Avenue, Suite 567E, Houston, TX, USA; The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.

出版信息

Crit Care Nurs Clin North Am. 2025 Mar;37(1):93-102. doi: 10.1016/j.cnc.2024.07.002. Epub 2024 Dec 17.

Abstract

One of the life-threatening adverse effects associated with the use of immune checkpoint inhibitors is β cells destruction resulting in type 1 diabetes. Immune checkpoint inhibitor-induced type 1 diabetes (ICI-T1D) usually has a rapid onset requiring admission to the intensive care unit for the management of diabetic ketoacidosis using an insulin drip protocol. Once stabilized patients with ICI-T1D are started on insulin therapy to mimic usual pancreatic function. Insulin administration may be through multiple daily injections or continuous subcutaneous insulin infusions using an insulin pump. People who develop ICI-T1D will require insulin therapy for life.

摘要

与使用免疫检查点抑制剂相关的危及生命的不良反应之一是β细胞破坏,导致1型糖尿病。免疫检查点抑制剂诱导的1型糖尿病(ICI-T1D)通常起病迅速,需要入住重症监护病房,使用胰岛素静脉滴注方案治疗糖尿病酮症酸中毒。一旦病情稳定,ICI-T1D患者开始接受胰岛素治疗,以模拟正常胰腺功能。胰岛素给药可通过每日多次注射或使用胰岛素泵进行持续皮下胰岛素输注。发生ICI-T1D的患者将终生需要胰岛素治疗。

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