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度伐利尤单抗诱发肺腺癌患者1型糖尿病:一例报告及文献综述

Durvalumab‑induced type 1 diabetes mellitus in lung adenocarcinoma: A case report and literature review.

作者信息

Dong Huijing, Li Shengfu, Peng Yanmei, Zhang Xu, Zheng Jiabin, Xue Chongxiang, Zheng Yumin, Yu Yixuan, Lu Xingyu, Hu Zixin, Cui Huijuan

机构信息

China-Japan Friendship Clinical Medical College, Beijing University of Chinese Medicine, Beijing 100029, P.R. China.

Department of Tuberculosis, Tai Yuan Fourth Peoples (Tuberculosis) Hospital, Taiyuan, Shanxi 030053, P.R. China.

出版信息

Oncol Lett. 2025 Apr 7;29(6):277. doi: 10.3892/ol.2025.15023. eCollection 2025 Jun.

Abstract

Immune checkpoint inhibitor-induced type 1 diabetes mellitus (ICI-T1DM) is a rare adverse reaction associated with durvalumab. Among the adverse reactions to durvalumab, the incidence of new-onset diabetes is relatively rare, occurring in ~0.2% of cases. The present study reports the case of a 62-year-old woman who developed ICI-T1DM following two cycles of durvalumab, presenting with thirst, polydipsia and polyuria. Laboratory examinations (glycated hemoglobin and glutamic acid decarboxylase antibody), along with consultations from an endocrinologist, led to the patient being diagnosed with ICI-T1DM. Immunotherapy was discontinued, and insulin replacement therapy was initiated. Blood glucose levels were closely monitored using a subcutaneous meter. The onset of diabetic ketoacidosis (DKA) was prevented due to timely treatment. In conclusion, medical oncologists need to be aware that durvalumab, an immunotherapy agent, can induce ICI-T1DM. Therefore, regular monitoring of blood glucose levels and collaborative consultations with endocrinologists are essential for an accurate diagnosis when elevated blood sugar levels are detected. The prompt diagnosis of ICI-T1DM is crucial to prevent the occurrence of DKA.

摘要

免疫检查点抑制剂诱导的1型糖尿病(ICI-T1DM)是一种与度伐利尤单抗相关的罕见不良反应。在度伐利尤单抗的不良反应中,新发糖尿病的发生率相对较低,约为0.2%。本研究报告了一例62岁女性患者,在接受两个周期的度伐利尤单抗治疗后发生了ICI-T1DM,出现口渴、多饮和多尿症状。实验室检查(糖化血红蛋白和谷氨酸脱羧酶抗体)以及内分泌科医生的会诊,最终确诊该患者为ICI-T1DM。免疫治疗停药,开始胰岛素替代治疗。使用皮下血糖仪密切监测血糖水平。由于及时治疗,预防了糖尿病酮症酸中毒(DKA)的发生。总之,肿瘤内科医生需要意识到,免疫治疗药物度伐利尤单抗可诱发ICI-T1DM。因此,当检测到血糖水平升高时,定期监测血糖水平并与内分泌科医生进行协作会诊对于准确诊断至关重要。ICI-T1DM的及时诊断对于预防DKA的发生至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97ca/12005073/8b5590e13789/ol-29-06-15023-g00.jpg

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