Introduction: Immune checkpoint inhibitor (ICI) induced type 1 diabetes (T1D) occurs in less than 1% of patients. It is unknown if glucose abnormalities prior to T1D diagnosis occur and in what fashion. We aimed to evaluate whether abnormal glucose trends precede ICI-T1D diagnosis.
Methods: We conducted a single-center retrospective study of patients with ICI-T1D after cancer treatment between 2010 and 2022. Characteristics assessed included serum glucose values at baseline, immediately prior to T1D, and at T1D diagnosis. Linear mixed model with random intercepts for each participant was used to examine glucose trend over time. To test effect modification of sex, age, BMI, autoantibodies, and DKA, interaction terms were added.
Results: Thirty-five patients had ICI-T1D. Median glucose levels were baseline=116 mg/dL (IQR 105-152), prior to T1D=170 mg/dL (IQR 130-298) and at T1D diagnosis=453 mg/dL (IQR 388-544) with median interval between of 16 days. Mixed model demonstrated significant increase in serum glucose of 6.02 mg/dL per day (95% CI 4.18, 7.85, p<0.001). Notably, females had larger increases in serum glucose per day than males (Figure 1).
Conclusion: Patients who develop ICI-T1D have abnormal serum glucose elevations prior to T1D diagnosis though rises were mild. Whether intervention utilizing continuous glucose monitoring could prevent morbidity requires further research.
J. Sharp: None. C. Pasadyn: None. S. Zhao: None. L. Wei: None. C. Presley: Advisory Panel; Regeneron Pharmaceuticals Inc. Other Relationship; Jazz Pharmaceuticals. D. Owen: Research Support; Merck & Co., Inc., Bristol-Myers Squibb Company, Palobiofarma, Genentech, Inc. Other Relationship; Genentech, Inc. Research Support; Pfizer Inc. K. Wyne: None. A.A. Meara: Consultant; AbbVie Inc., Sanofi, Amgen Inc., AstraZeneca.
