Table 4

Disease characteristics and course of individual patients with PD-1 inhibitor-induced worsening of pre-existing type 2 diabetes

PtBMIICIPre-ICI laboratory dataPresentationDoses/time (months) to presentationOther IRAETherapy
1333.3NivolumabFPG 166 mg/dL, HbA1c 8.1%.HbA1c 10%, FPG 300 mg/dL, RPG 580 mg/dL.2/3.9Thyroiditis.TZD and basal insulin.
1424.4NivolumabFPG 197 mg/dL, RPG 273 mg/dL, HbA1c 8.2%HbA1c 10%, RPG 378 mg/dL, FPG 311 mg/dL, β-OHB 1.8 mmol/L; methylprednisolone 1000 mg daily for 1 week.4/5.7Dermatitis; secondary adrenal insufficiency.MDI.
1525.5PembrolizumabFPG 104 mg/dL, HbA1c 6.2%.HbA1c 8.6%, RPG 239 mg/dL, FPG 190 mg/dL.12/5Thyroiditis.Basal insulin.
1627.1PembrolizumabFPG 111 mg/dL, RPG 132 mg/dL, HbA1c 8%.HbA1c 11.3%, RPG 367 mg/dL, FPG 222 mg/dL.5/3.8Ocular.Metformin and MDI.
1737.9PembrolizumabFPG 121 mg/dL, HbA1c 7.4%.FPG 208 mg/dL, HbA1c 9%.4/1.4MDI
1845.2PembrolizumabFPG 140 mg/dL, HbA1c 6.6%.FPG 230 mg/dL, RPG 249 mg/dL, HbA1c 8.1%, dexamethasone 2 g daily for 5 months.3/6.9Thyroiditis and hypophysitis.Metformin and MDI.
1927.5Ipilimumab → PembrolizumabFPG 117 mg/dL.FPG 304 mg/dL, HbA1c 11.8%.13/12.3Hepatitis.MDI.
2032.3NivolumabFPG 112 mg/dL, RPG 158 mg/dL, HbA1c 8.8%.FPG 154 mg/dL, RPG 180 mg/dL, HbA1c 9.5%, GGT 257 IU/L, dexamethasone 8 g daily for 1 week.1/1.8Thyroiditis.MDI.
2118.4PembrolizumabFPG 141 mg/dL, RPG 235 mg/dL, HbA1c 9.2%.FPG 606 mg/dL, RPG 999 mg/dL, HbA1c 12%.3/1.7MDI.
  • BMI, body mass index; FPG, fasting plasma glucose; HbA1c, hemoglobin A1c; IA-2, islet antigen 2; IAA, insulin autoantibodies; IRAE, immune-related adverse events; MDI, multiple daily injections of insulin; RPG, random plasma glucose; TZD, Thiazolidinedione.