Immune-checkpoint inhibitor-associated diabetes compared to other diabetes types - A prospective, matched control study

DPV Initiative

doi:10.1111/1753-0407.13215

Immune-checkpoint inhibitor-associated diabetes compared to other diabetes types - A prospective, matched control study

DPV Initiative

Abstract

Background: To describe checkpoint inhibitor-induced diabetes mellitus (CPI-DM) and to compare with regular type 1 (T1DM), type 2 (T2DM), and medication-induced diabetes mellitus (MI-DM). Methods: We included 88 177 adult patients from the Diabetes Patient Follow-Up (DPV) registry with diabetes manifestation between 2011 and 2020. Inclusion criteria were T1DM, T2DM, MI-DM, or CPI-DM. Because of the heterogeneity between the groups, we matched patients by age, sex, and diabetes duration using propensity scores. Patient data were aggregated in the respective first documented treatment year. Results: The matched cohort consisted of 24 164 patients; T1DM: 29, T2DM: 24000, MI-DM: 120, CPI-DM: 15 patients. Median age at manifestation of CPI-DM patients was 63.6 (57.2-72.8) years (53.3% male). Body mass index in CPI-DM patients was significantly lower (26.8 [23.9-28.1] kg/m²) compared with T2DM patients (29.8 [26.2-34.3] kg/m², P = 0.02). At manifestation, HbA1c was significantly higher in CPI-DM compared with MI-DM, but there was no difference during follow-up. Diabetic ketoacidosis (DKA) was documented in six CPI-DM patients (T1DM: 0%, T2DM: 0.4%, MI-DM: 0.0%). Fourteen CPI-DM patients were treated with insulin, and three received additional oral antidiabetics. The most common therapy in T2DM was lifestyle modification (38.8%), insulin in MI-DM (52.5%). Concomitant autoimmune thyroid disease was present in four CPI-DM patients (T1DM: 0.0%, T2DM: 1.0%, MI-DM: 0.8%). Conclusions: The data from this controlled study show that CPI-DM is characterized by a high prevalence of DKA, autoimmune comorbidity, and metabolic decompensation at onset. Structured diagnostic monitoring is warranted to prevent DKA and other acute endocrine complications in CPI-treated patients.

Original language	English
Journal	Journal of Diabetes
Volume	13
Issue number	12
Pages (from-to)	1007-1014
Number of pages	8
ISSN	1753-0393
DOIs	https://doi.org/10.1111/1753-0407.13215
Publication status	Published - 12.2021

Funding

Special thanks to A. Hungele and R. Ranz for development of the DPV documentation software, K. Fink and E. Bollow for the DPV data management (clinical data managers, Ulm University), and Stefanie Lanzinger, PhD, for checking the statistical program and revising the manuscript. We further thank all centers contributing to this analysis: Aachen-Innere RWTH, Aidlingen Praxisgemeinschaft, Alt?tting-Burghausen Innere Medizin, Asbach Kamillus-Klinik Innere, Augsburg IV. Med. Uni-Klinik, Bad Aibling Internist. Praxis, Bad Aibling Internist. Praxis-2, Bad Driburg/Bad Hermannsborn Innere, Bad Hersfeld Innere, Bad Reichenhall Kreisklinik Innere Med., Bad S?ckingen Hochrheinklinik Innere, Bayreuth Innere Medizin, Bensheim Heilig Geist Innere, Bergen Gemeinschaftspraxis, Berlin DRK-Kliniken Mitte Innere, Berlin Endokrinologikum, Berlin Evang. Krankenhaus K?nigin Elisabeth, Berlin Klinik St. Hedwig Innere, Berlin Oskar Zieten Krankenhaus Innere, Berlin Parkklinik Weissensee, Berlin Schlosspark-Klinik Innere, Berlin St. Josephskrankenhaus Innere, Berlin Vivantes Hellersdorf Innere, Bonn Schwerpunktpraxis, Bottrop Knappschaftskrankenhaus Innere, Bremen-Mitte Innere, Castrop-Rauxel Evangelisches Krankenhaus, Castrop-Rauxel Rochus-Hospital, Chemnitz-Hartmannsdorf Innere Medizin-DIAKOMED-1, Coburg Innere Medizin, Coesfeld/D?lmen Innere Med., Darmstadt Innere Medizin, Deggendorf Gemeinschaftspraxis, Deggendorf Medizinische Klinik II, Dortmund Knappschaftskrankenhaus Innere, Dortmund Medizinische Kliniken Nord, Dortmund-Hombruch Marienhospital, Dortmund-St. Josefshospital Innere, Dortmund-West Innere, Duisburg Malteser Rhein-Ruhr St. Anna Innere, Duisburg Malteser St. Johannes, Duisburg-Huckingen, Duisburg-Huckingen Malteser Rhein-Ruhr ST. Johannes, Duisburg-St.Johannes Helios, Eberswalde Klinikum Barnim Werner For?mann-Innere, Eckernf?rde Gem.-Prax, Eisleben Lutherstadt Helios-Klinik, Erlangen Uni Innere Medizin, Essen Diabetes-SPP, Essen Diabetes-Schwerpunktpraxis, Forchheim Diabeteszentrum SPP, Frankfurt Diabeteszentrum Rhein-Main-Erwachsenendiabetologie (B?rgerhospital), Frankfurt Uni-Klinik Innere, Frankfurt Uni-Klinik Innere2, Frankfurt-Sachsenhausen Innere, Frankfurt-Sachsenhausen Innere MVZ, Freiburg Uni Innere, Friedberg Innere Klinik, Geislingen Klinik Helfenstein Innere, Gelnhausen Innere, Gie?en Ev. Krankenhaus Mittelhessen, G?ppingen Innere Medizin, G?ttingen Uni Gastroenterologie, G?strow Innere, Halberstadt Innere Med. AMEOS Klinik, Hamburg Endokrinologikum, Hanau diabetol. Schwerpunktpraxis, Hannover DM-SPP, Heidelberg St. Josefskrankenhaus, Heidenheim Arztpraxis Allgemeinmed, Heilbronn Innere Klinik, Herdecke Kinderklinik, Herford Innere Med I, Herne Evan. Krankenhaus Innere, Herten St. Elisabeth Innere Medizin, Hildburghausen Hennebergklinik, Hildesheim GmbH - Innere, Hohenm?lsen Diabeteszentrum, Idar Oberstein Schwerpunktpraxis, Innsbruck Universit?tsklinik Innere, Iserlohn Innere Medizin, Kamen Klinikum Westfalen Hellmig Krankenhaus, Kamen MKK - Medizinisches Kompetenzkollegium, Karlsburg Klinik f?r Diabetes & Stoffwechsel, Karlsruhe Schwerpunktpraxis, Kempen Heilig Geist - Innere, Kempen Heilig Geist-KHS-Innere, Kirchheim-N?rtingen Innere, Kleve Innere Medizin, Koblenz Kemperhof 1. Med. Klinik, Koblenz Kemperhof 1. Mediz. Klinik, Konstanz Innere Klinik, Krefeld Alexianer Innere, Krefeld Innere Klinik, Krefeld-Uerdingen St. Josef Innere, Landau Innere, Lilienthal Diabeteszentrum, Limburg Innere Medizin, Lindenfels Luisenkrankenhaus Innere, Lindenfels Luisenkrankenhaus Innere 2, Lindlar DM-Zentrum, Linz Krankenhaus Barmherzige Schwestern Kardiologie Abt. Int. II, Ludwigshafen diabetol. SPP, L?beck Uni-Klinik Innere Medizin, L?nen Klinik am Park, Magdeburg St?dtisches Klinikum Innere, Malchower See Rehaklinik, Manderscheid Rathauspraxis, Marburg - UKGM Endokrinologie & Diabetes, Marktredwitz Innere Medizin, Memmingen Internistische Praxis, Murnau am Staffelsee - diabetol. SPP, M?nchen Diabetes-Zentrum S?d, M?nster Herz Jesu Innere, M?nster Ludgerus-Kliniken GmbH, Neumarkt Innere, Neunkirchen Innere Medizin, Neuwied Marienhaus Klinikum St. Elisabeth Innere, Nidda Bad Salzhausen Klinik Rabenstein/Innere-1 Reha, Nidda Bad Salzhausen Klinik Rabenstein/Innere-2 Reha, N?rnberg Uniklinik Med. Klinik 4, Oberhausen Innere, Oberndorf Gastroenterologische Praxis Schwerpunkt Diabetologie, Offenbach/Main Innere Medizin, Oschersleben MEDIGREIF B?rdekrankenhaus, Ottobeuren Kreiskrankenhaus, Pfullendorf Innere Medizin, Pirmasens St?dtisches Krankenhaus Innere, Plauen Vogtlandklinikum, Prenzlau Krankenhaus Innere, Rastatt Kreiskrankenhaus Innere, Reutlingen Klinikum Steinenberg Innere, Rodalben St. Elisabeth, Rosenheim Innere Medizin, Rosenheim Schwerpunktpraxis, Rostock Universit?t Innere Medizin, Rottweil Gemeinschaftspraxis, Ruit Medius-Kliniken Innere, Saaldorf-Surheim Diabetespraxis, Scheidegg Prinzregent Luitpold, Schwerin Innere Medizin, Schw?bisch Hall Diakonie Innere Medizin, Spaichingen Innere, Stuttgart Sana Klinik Bethesda, Tettnang Innere Medizin, Timmendorfer Strand, Traunstein diabetol. Schwerpunktpraxis, Trostberg Innere, Ulm Agaplesion Bethesda-Krankenhaus, Ulm Schwerpunktpraxis Bahnhofsplatz, Viersen internist. Praxis, Villingen-Schwenningen Schwarzwald-Baar-Klinikum Innere, Wangen Oberschwabenklinik Innere Medizin, Weisswasser Kreiskrankenhaus, Wernberg-K?blitz SPP, Witten Kinderarztpraxis, Wittenberg Innere Medizin, Wittlich DSP, Wolgast Innere Medizin, Worms Schwerpunktpraxis, W?rth am Main SPP, and Zweibr?cken Ev. KH. Innere. This work was supported by the German Centre of Diabetes Research (DZD) funded by the Federal Ministry of Education and Research (FKZ 82DZD14A02). The German Diabetes Association (DDG), the Robert Koch Institute (RKI), the Innovative Medicines Initiative 2 Joint Undertaking (INNODIA, grant agreement 115797), and INNODIA Harvest (grant agreement 945268) provided further financial support for the DPV registry. Open Access funding enabled and organized by Projekt DEAL. Special thanks to A. Hungele and R. Ranz for development of the DPV documentation software, K. Fink and E. Bollow for the DPV data management (clinical data managers, Ulm University), and Stefanie Lanzinger, PhD, for checking the statistical program and revising the manuscript. We further thank all centers contributing to this analysis: Aachen‐Innere RWTH, Aidlingen Praxisgemeinschaft, Altötting‐Burghausen Innere Medizin, Asbach Kamillus‐Klinik Innere, Augsburg IV. Med. Uni‐Klinik, Bad Aibling Internist. Praxis, Bad Aibling Internist. Praxis‐2, Bad Driburg/Bad Hermannsborn Innere, Bad Hersfeld Innere, Bad Reichenhall Kreisklinik Innere Med., Bad Säckingen Hochrheinklinik Innere, Bayreuth Innere Medizin, Bensheim Heilig Geist Innere, Bergen Gemeinschaftspraxis, Berlin DRK‐Kliniken Mitte Innere, Berlin Endokrinologikum, Berlin Evang. Krankenhaus Königin Elisabeth, Berlin Klinik St. Hedwig Innere, Berlin Oskar Zieten Krankenhaus Innere, Berlin Parkklinik Weissensee, Berlin Schlosspark‐Klinik Innere, Berlin St. Josephskrankenhaus Innere, Berlin Vivantes Hellersdorf Innere, Bonn Schwerpunktpraxis, Bottrop Knappschaftskrankenhaus Innere, Bremen‐Mitte Innere, Castrop‐Rauxel Evangelisches Krankenhaus, Castrop‐Rauxel Rochus‐Hospital, Chemnitz‐Hartmannsdorf Innere Medizin‐DIAKOMED‐1, Coburg Innere Medizin, Coesfeld/Dülmen Innere Med., Darmstadt Innere Medizin, Deggendorf Gemeinschaftspraxis, Deggendorf Medizinische Klinik II, Dortmund Knappschaftskrankenhaus Innere, Dortmund Medizinische Kliniken Nord, Dortmund‐Hombruch Marienhospital, Dortmund‐St. Josefshospital Innere, Dortmund‐West Innere, Duisburg Malteser Rhein‐Ruhr St. Anna Innere, Duisburg Malteser St. Johannes, Duisburg‐Huckingen, Duisburg‐Huckingen Malteser Rhein‐Ruhr ST. Johannes, Duisburg‐St.Johannes Helios, Eberswalde Klinikum Barnim Werner Forßmann‐Innere, Eckernförde Gem.‐Prax, Eisleben Lutherstadt Helios‐Klinik, Erlangen Uni Innere Medizin, Essen Diabetes‐SPP, Essen Diabetes‐Schwerpunktpraxis, Forchheim Diabeteszentrum SPP, Frankfurt Diabeteszentrum Rhein‐Main‐Erwachsenendiabetologie (Bürgerhospital), Frankfurt Uni‐Klinik Innere, Frankfurt Uni‐Klinik Innere2, Frankfurt‐Sachsenhausen Innere, Frankfurt‐Sachsenhausen Innere MVZ, Freiburg Uni Innere, Friedberg Innere Klinik, Geislingen Klinik Helfenstein Innere, Gelnhausen Innere, Gießen Ev. Krankenhaus Mittelhessen, Göppingen Innere Medizin, Göttingen Uni Gastroenterologie, Güstrow Innere, Halberstadt Innere Med. AMEOS Klinik, Hamburg Endokrinologikum, Hanau diabetol. Schwerpunktpraxis, Hannover DM‐SPP, Heidelberg St. Josefskrankenhaus, Heidenheim Arztpraxis Allgemeinmed, Heilbronn Innere Klinik, Herdecke Kinderklinik, Herford Innere Med I, Herne Evan. Krankenhaus Innere, Herten St. Elisabeth Innere Medizin, Hildburghausen Hennebergklinik, Hildesheim GmbH ‐ Innere, Hohenmölsen Diabeteszentrum, Idar Oberstein Schwerpunktpraxis, Innsbruck Universitätsklinik Innere, Iserlohn Innere Medizin, Kamen Klinikum Westfalen Hellmig Krankenhaus, Kamen MKK ‐ Medizinisches Kompetenzkollegium, Karlsburg Klinik für Diabetes & Stoffwechsel, Karlsruhe Schwerpunktpraxis, Kempen Heilig Geist ‐ Innere, Kempen Heilig Geist‐KHS‐Innere, Kirchheim‐Nürtingen Innere, Kleve Innere Medizin, Koblenz Kemperhof 1. Med. Klinik, Koblenz Kemperhof 1. Mediz. Klinik, Konstanz Innere Klinik, Krefeld Alexianer Innere, Krefeld Innere Klinik, Krefeld‐Uerdingen St. Josef Innere, Landau Innere, Lilienthal Diabeteszentrum, Limburg Innere Medizin, Lindenfels Luisenkrankenhaus Innere, Lindenfels Luisenkrankenhaus Innere 2, Lindlar DM‐Zentrum, Linz Krankenhaus Barmherzige Schwestern Kardiologie Abt. Int. II, Ludwigshafen diabetol. SPP, Lübeck Uni‐Klinik Innere Medizin, Lünen Klinik am Park, Magdeburg Städtisches Klinikum Innere, Malchower See Rehaklinik, Manderscheid Rathauspraxis, Marburg ‐ UKGM Endokrinologie & Diabetes, Marktredwitz Innere Medizin, Memmingen Internistische Praxis, Murnau am Staffelsee ‐ diabetol. SPP, München Diabetes‐Zentrum Süd, Münster Herz Jesu Innere, Münster Ludgerus‐Kliniken GmbH, Neumarkt Innere, Neunkirchen Innere Medizin, Neuwied Marienhaus Klinikum St. Elisabeth Innere, Nidda Bad Salzhausen Klinik Rabenstein/Innere‐1 Reha, Nidda Bad Salzhausen Klinik Rabenstein/Innere‐2 Reha, Nürnberg Uniklinik Med. Klinik 4, Oberhausen Innere, Oberndorf Gastroenterologische Praxis Schwerpunkt Diabetologie, Offenbach/Main Innere Medizin, Oschersleben MEDIGREIF Bördekrankenhaus, Ottobeuren Kreiskrankenhaus, Pfullendorf Innere Medizin, Pirmasens Städtisches Krankenhaus Innere, Plauen Vogtlandklinikum, Prenzlau Krankenhaus Innere, Rastatt Kreiskrankenhaus Innere, Reutlingen Klinikum Steinenberg Innere, Rodalben St. Elisabeth, Rosenheim Innere Medizin, Rosenheim Schwerpunktpraxis, Rostock Universität Innere Medizin, Rottweil Gemeinschaftspraxis, Ruit Medius‐Kliniken Innere, Saaldorf‐Surheim Diabetespraxis, Scheidegg Prinzregent Luitpold, Schwerin Innere Medizin, Schwäbisch Hall Diakonie Innere Medizin, Spaichingen Innere, Stuttgart Sana Klinik Bethesda, Tettnang Innere Medizin, Timmendorfer Strand, Traunstein diabetol. Schwerpunktpraxis, Trostberg Innere, Ulm Agaplesion Bethesda‐Krankenhaus, Ulm Schwerpunktpraxis Bahnhofsplatz, Viersen internist. Praxis, Villingen‐Schwenningen Schwarzwald‐Baar‐Klinikum Innere, Wangen Oberschwabenklinik Innere Medizin, Weisswasser Kreiskrankenhaus, Wernberg‐Köblitz SPP, Witten Kinderarztpraxis, Wittenberg Innere Medizin, Wittlich DSP, Wolgast Innere Medizin, Worms Schwerpunktpraxis, Wörth am Main SPP, and Zweibrücken Ev. KH. Innere. This work was supported by the German Centre of Diabetes Research (DZD) funded by the Federal Ministry of Education and Research (FKZ 82DZD14A02). The German Diabetes Association (DDG), the Robert Koch Institute (RKI), the Innovative Medicines Initiative 2 Joint Undertaking (INNODIA, grant agreement 115797), and INNODIA Harvest (grant agreement 945268) provided further financial support for the DPV registry. Open Access funding enabled and organized by Projekt DEAL. Federal Ministry of Education and Research, Grant/Award Number: FKZ 82DZD14A02; German Diabetes Association (DDG); INNODIA Harvest, Grant/Award Number: 945268; Innovative Medicines Initiative 2 Joint Undertaking (INNODIA), Grant/Award Number: 115797; Robert Koch Institute (RKI); Ulm University Funding information

Research Areas and Centers

Academic Focus: Center for Brain, Behavior and Metabolism (CBBM)

DFG Research Classification Scheme

2.22-17 Endocrinology, Diabetology, Metabolism

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/1753-0407.13215

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@article{20c146a7a2dc4c8497756549b8e95b3f,

title = "Immune-checkpoint inhibitor-associated diabetes compared to other diabetes types - A prospective, matched control study",

abstract = "Background: To describe checkpoint inhibitor-induced diabetes mellitus (CPI-DM) and to compare with regular type 1 (T1DM), type 2 (T2DM), and medication-induced diabetes mellitus (MI-DM). Methods: We included 88 177 adult patients from the Diabetes Patient Follow-Up (DPV) registry with diabetes manifestation between 2011 and 2020. Inclusion criteria were T1DM, T2DM, MI-DM, or CPI-DM. Because of the heterogeneity between the groups, we matched patients by age, sex, and diabetes duration using propensity scores. Patient data were aggregated in the respective first documented treatment year. Results: The matched cohort consisted of 24 164 patients; T1DM: 29, T2DM: 24000, MI-DM: 120, CPI-DM: 15 patients. Median age at manifestation of CPI-DM patients was 63.6 (57.2-72.8) years (53.3% male). Body mass index in CPI-DM patients was significantly lower (26.8 [23.9-28.1] kg/m2) compared with T2DM patients (29.8 [26.2-34.3] kg/m2, P = 0.02). At manifestation, HbA1c was significantly higher in CPI-DM compared with MI-DM, but there was no difference during follow-up. Diabetic ketoacidosis (DKA) was documented in six CPI-DM patients (T1DM: 0%, T2DM: 0.4%, MI-DM: 0.0%). Fourteen CPI-DM patients were treated with insulin, and three received additional oral antidiabetics. The most common therapy in T2DM was lifestyle modification (38.8%), insulin in MI-DM (52.5%). Concomitant autoimmune thyroid disease was present in four CPI-DM patients (T1DM: 0.0%, T2DM: 1.0%, MI-DM: 0.8%). Conclusions: The data from this controlled study show that CPI-DM is characterized by a high prevalence of DKA, autoimmune comorbidity, and metabolic decompensation at onset. Structured diagnostic monitoring is warranted to prevent DKA and other acute endocrine complications in CPI-treated patients.",

author = "{DPV Initiative} and Tittel, {Sascha R.} and Katharina Laubner and Schmid, {Sebastian M.} and Stefan Kress and Sigrun Merger and Wolfram Karges and Wosch, {Frank J.} and Marcus Altmeier and Marianne Pavel and Holl, {Reinhard W.}",

note = "Publisher Copyright: {\textcopyright} 2021 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai JiaoTong University School of Medicine and John Wiley & Sons Australia, Ltd.",

year = "2021",

month = dec,

doi = "10.1111/1753-0407.13215",

language = "English",

volume = "13",

pages = "1007--1014",

journal = "Journal of Diabetes",

issn = "1753-0393",

publisher = "Wiley-Blackwell",

number = "12",

}

TY - JOUR

T1 - Immune-checkpoint inhibitor-associated diabetes compared to other diabetes types - A prospective, matched control study

AU - DPV Initiative

AU - Tittel, Sascha R.

AU - Laubner, Katharina

AU - Schmid, Sebastian M.

AU - Kress, Stefan

AU - Merger, Sigrun

AU - Karges, Wolfram

AU - Wosch, Frank J.

AU - Altmeier, Marcus

AU - Pavel, Marianne

AU - Holl, Reinhard W.

PY - 2021/12

Y1 - 2021/12

N2 - Background: To describe checkpoint inhibitor-induced diabetes mellitus (CPI-DM) and to compare with regular type 1 (T1DM), type 2 (T2DM), and medication-induced diabetes mellitus (MI-DM). Methods: We included 88 177 adult patients from the Diabetes Patient Follow-Up (DPV) registry with diabetes manifestation between 2011 and 2020. Inclusion criteria were T1DM, T2DM, MI-DM, or CPI-DM. Because of the heterogeneity between the groups, we matched patients by age, sex, and diabetes duration using propensity scores. Patient data were aggregated in the respective first documented treatment year. Results: The matched cohort consisted of 24 164 patients; T1DM: 29, T2DM: 24000, MI-DM: 120, CPI-DM: 15 patients. Median age at manifestation of CPI-DM patients was 63.6 (57.2-72.8) years (53.3% male). Body mass index in CPI-DM patients was significantly lower (26.8 [23.9-28.1] kg/m2) compared with T2DM patients (29.8 [26.2-34.3] kg/m2, P = 0.02). At manifestation, HbA1c was significantly higher in CPI-DM compared with MI-DM, but there was no difference during follow-up. Diabetic ketoacidosis (DKA) was documented in six CPI-DM patients (T1DM: 0%, T2DM: 0.4%, MI-DM: 0.0%). Fourteen CPI-DM patients were treated with insulin, and three received additional oral antidiabetics. The most common therapy in T2DM was lifestyle modification (38.8%), insulin in MI-DM (52.5%). Concomitant autoimmune thyroid disease was present in four CPI-DM patients (T1DM: 0.0%, T2DM: 1.0%, MI-DM: 0.8%). Conclusions: The data from this controlled study show that CPI-DM is characterized by a high prevalence of DKA, autoimmune comorbidity, and metabolic decompensation at onset. Structured diagnostic monitoring is warranted to prevent DKA and other acute endocrine complications in CPI-treated patients.

AB - Background: To describe checkpoint inhibitor-induced diabetes mellitus (CPI-DM) and to compare with regular type 1 (T1DM), type 2 (T2DM), and medication-induced diabetes mellitus (MI-DM). Methods: We included 88 177 adult patients from the Diabetes Patient Follow-Up (DPV) registry with diabetes manifestation between 2011 and 2020. Inclusion criteria were T1DM, T2DM, MI-DM, or CPI-DM. Because of the heterogeneity between the groups, we matched patients by age, sex, and diabetes duration using propensity scores. Patient data were aggregated in the respective first documented treatment year. Results: The matched cohort consisted of 24 164 patients; T1DM: 29, T2DM: 24000, MI-DM: 120, CPI-DM: 15 patients. Median age at manifestation of CPI-DM patients was 63.6 (57.2-72.8) years (53.3% male). Body mass index in CPI-DM patients was significantly lower (26.8 [23.9-28.1] kg/m2) compared with T2DM patients (29.8 [26.2-34.3] kg/m2, P = 0.02). At manifestation, HbA1c was significantly higher in CPI-DM compared with MI-DM, but there was no difference during follow-up. Diabetic ketoacidosis (DKA) was documented in six CPI-DM patients (T1DM: 0%, T2DM: 0.4%, MI-DM: 0.0%). Fourteen CPI-DM patients were treated with insulin, and three received additional oral antidiabetics. The most common therapy in T2DM was lifestyle modification (38.8%), insulin in MI-DM (52.5%). Concomitant autoimmune thyroid disease was present in four CPI-DM patients (T1DM: 0.0%, T2DM: 1.0%, MI-DM: 0.8%). Conclusions: The data from this controlled study show that CPI-DM is characterized by a high prevalence of DKA, autoimmune comorbidity, and metabolic decompensation at onset. Structured diagnostic monitoring is warranted to prevent DKA and other acute endocrine complications in CPI-treated patients.

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U2 - 10.1111/1753-0407.13215

DO - 10.1111/1753-0407.13215

M3 - Journal articles

C2 - 34275207

AN - SCOPUS:85111971785

SN - 1753-0393

VL - 13

SP - 1007

EP - 1014

JO - Journal of Diabetes

JF - Journal of Diabetes

IS - 12

ER -

Immune-checkpoint inhibitor-associated diabetes compared to other diabetes types - A prospective, matched control study

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UN SDGs

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