ECE2023 Rapid Communications Rapid Communications 11: Late Breaking (6 abstracts)
Immune checkpoint inhibitors and severe insulinopenic diabetes mellitus: A single center experience
Ruti Karov 1 , Roy Eldor 1 , Tamara Kolitz 1 , Michal Ehrenwald 1 , Eugene Feigin 1 & Yona Greenman 1
1Tel Aviv-Souraski Medical Center, Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv-Yafo, Israel
Introduction: Severe insulinopenic diabetes (SID) is a rare complication of treatment with immune checkpoint inhibitors (ICPI). We describe herein the clinical characteristics, natural history and potential predictors of SID in cancer patients treated with ICPI.
Methods: We identified and retrospectively retrieved pertinent clinical data of all patients who presented with new onset SID following treatment with ICPI between 2015 and 2022 at the Tel Aviv-Sourasky Medical Center.
Results: The study cohort comprised 1621 ICPI-trated patients, of whom 12 patients (0.8%) developed SID. Seven were males (53.8%). Median age was 67 (IQR 60.5-77) years. Eight patients (61.5%) were treated with PD-L1 inhibitors, 3 (23.1%) with PD-1 inhibitors and 2 (15.4%) with a combination of PD1 and CTLA4 inhibitors . Two patients had a prior diagnosis of type 2 diabetes treated with oral medications while 2 other patients had a prior diagnosis of impaired fasting glucose. Three patients (23.1%) developed a concomitant thyroid dysfunction under ICPI. Median time from the initiation of ICPI to presentation of SID was 4 months (IQR 1-9). Five of the patients presented with SID within a month from exposure (38.5%). DKA was the presenting symptom in eleven patients (84.6%), 3 of which were treated with a SGLT2i . One patient (7.7%) died within one week of DKA presentation.
Conclusions: This is one of the largest single center series describing the onset and characteristics of SID following ICPI treatment.
Volume 90
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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