Early Detection of Type 1 Diabetes Mellitus Due to Nivolumab by Self-measurement of Urinary Glucose Levels in a 71-year-old Woman

DOI
  • Kawanabe Shin
    Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Nakagawa Tomoko
    Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Uchiyama Shutarou
    Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Nakamura Yuta
    Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Tsukiyama Hidekazu
    Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Yokota Kenichi
    Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine
  • Sone Masakatsu
    Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine

Bibliographic Information

Other Title
  • 免疫関連有害事象の早期診断のため尿糖自己測定が有用であったニボルマブによる1型糖尿病の1例

Abstract

<p>A 71-year-old woman with recurrent esophageal cancer was treated with nivolumab. For the early detection of type 1 diabetes caused by immune-related adverse events (irAEs), the patient was instructed to self-measure urinary glucose levels at the start of drug therapy. After 22 courses of treatment, the patient tested positive for urinary glucose and presented to our hospital with fatigue. Laboratory investigations revealed hyperglycemia (blood glucose, 352 mg/dL); however, her glycosylated hemoglobin (HbA1c) level was relatively low at 6.6 %, with no urinary ketones or acidosis. Due to her rapidly rising blood glucose levels, we suspected the development of type 1 diabetes mellitus caused by nivolumab and initiated insulin therapy. Subsequently, the chemotherapy regimen was changed; however, the patient was hospitalized because of diabetic ketoacidosis. Therefore, the patient was diagnosed with type 1 diabetes caused by irAEs due to low C-peptide levels in her blood and urine. At our hospital, we instruct patients to self-monitor their urine glucose levels when they were being treated with immune checkpoint inhibitors. This guidance may help to detect the onset of type 1 diabetes at an early stage and prevent the development severe disease.</p>

Journal

Details 詳細情報について

  • CRID
    1390581456540244352
  • DOI
    10.11213/tonyobyo.67.173
  • ISSN
    1881588X
    0021437X
  • Text Lang
    ja
  • Data Source
    • JaLC
  • Abstract License Flag
    Disallowed

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