[Clinical characteristics of immune checkpoint inhibitor-related type 1 diabetes mellitus].

The clinical data of ten patients with immune checkpoint inhibitor-related type 1 diabetes mellitus were enrolled in the Second Xiangya Hospital of Central South University from January 2020 to October 2022 including 9 males and 1 female, with an average age of (57±8) years. There were 7 cases of fulminant type 1 diabetes and 3 cases of acute type 1 diabetes. Among the 10 patients, there were 5 cases of lung cancer, 2 cases of esophageal cancer, 1 case of gastric carcinom, 1 case of renal cell carcinoma, and 1 case of nasopharyngeal cancer. The drugs used in 10 patients were all programmed cell death receptor 1 (PD-1) inhibitors, including 5 cases of pembrolizumab, 3 cases of sintilimab, 1 case of tanezumab, and 1 case of toripalimab. Among them, 8 patients had diabetic ketoacidosis (DKA), 1 patient had ketosis, and 1 case had no ketosis at onset; 9 patients were negative for diabetes-related antibodies, and 1 patient was positive. All the 10 patients were successfully treated and depended on insulin therapy. Immune checkpoint inhibitors can cause type 1 diabetes, including fulminant type 1 diabetes, which mostly begins with DKA, requiring early identification and aggressive insulin therapy.收集2020年1月至2022年10月于中南大学湘雅二医院就诊的10例免疫检查点抑制剂相关1型糖尿病患者的临床资料，男9例，女1例，年龄（57±8）岁，其中暴发性1型糖尿病7例，急性1型糖尿病3例。10例中肺癌5例，食管癌2例，胃癌、肾细胞癌、鼻咽癌各1例。10例患者所使用的药物均为程序性细胞死亡受体1抑制剂，其中派姆单抗5例，信迪利单抗3例，替雷珠单抗1例，特瑞普利单抗1例。其中8例以糖尿病酮症酸中毒起病，1例以糖尿病酮症起病，1例起病时无酮症；9例胰岛相关抗体阴性，另1例阳性。10例均获得成功救治，且依赖胰岛素治疗。免疫检查点抑制剂可导致1型糖尿病，包括暴发性1型糖尿病，多以糖尿病酮症酸中毒起病，需要早期识别，积极胰岛素治疗。.