scholarly journals Nivolumab‐induced fulminant type 1 diabetes with precipitous fall in C‐peptide level

2019 ◽  
Vol 11 (3) ◽  
pp. 748-749 ◽  
Author(s):  
Masaaki Miyauchi ◽  
Masao Toyoda ◽  
Jie Zhang ◽  
Naoko Hamada ◽  
Takashi Yamawaki ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Fulminant Type 1 Diabetes ◽  
C Peptide ◽  
Peptide Level ◽  
Fulminant Type

scholarly journals Pembrolizumab-induced fulminant type 1 diabetes with C-peptide persistence at first referral

2020 ◽  
Vol 2020 ◽  
Author(s):  
Kazuhisa Kusuki ◽  
Saya Suzuki ◽  
Yuzo Mizuno
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Fulminant Type 1 Diabetes ◽  
C Peptide ◽  
Outpatient Visits ◽  
Peptide Level ◽  
Life Threatening ◽  
History Of ◽  
Fulminant Type

Summary A 72-year-old man with no history of diabetes was referred to our department due to hyperglycemia during pembrolizumab treatment for non-small-cell lung carcinoma. His blood glucose level was 209 mg/dL, but he was not in a state of ketosis or ketoacidosis. Serum C-peptide levels persisted at first, but gradually decreased, and 18 days later, he was admitted to our hospital with diabetic ketoacidosis (DKA). The patient was diagnosed with fulminant type 1 diabetes (FT1D) induced by pembrolizumab. According to the literature, the insulin secretion capacity of a patient with type 1 diabetes (T1D) induced by anti-programmed cell death-1 (anti-PD-1) antibody is depleted in approximately 2 to 3 weeks, which is longer than that of typical FT1D. Patients with hyperglycemia and C-peptide persistence should be considered for hospitalization or frequent outpatient visits with insulin treatment because these could indicate the onset of life-threatening FT1D induced by anti-PD-1 antibodies. Based on the clinical course of this patient and the literature, we suggest monitoring anti-PD-1 antibody-related T1D. Learning points: Immune checkpoint inhibitors, such as anti-PD-1 antibodies, are increasingly used as anticancer drugs. Anti-PD-1 antibodies can cause immune-related adverse events, including T1D. FT1D, a novel subtype of T1D, is characterized by the abrupt onset of hyperglycemia with ketoacidosis, a relatively low glycated hemoglobin level and depletion of C-peptide level at onset. In patients being treated with anti-PD-1 antibody, hyperglycemia with C-peptide level persistence should be monitored through regular blood tests. Because of C-peptide persistence and mild hyperglycemia, it is possible to miss a diagnosis of life-threatening FT1D induced by anti-PD-1 antibody. In particular, in patients who have no history of diabetes, hyperglycemia without DKA is likely to be the very beginning of anti-PD-1 antibody-induced T1D. Therefore, such patients must be considered for either hospitalization or frequent outpatient visits with insulin injections and self-monitoring of blood glucose.

scholarly journals A Patient with Nivolumab-related Fulminant Type 1 Diabetes Mellitus whose Serum C-peptide Level Was Preserved at the Initial Detection of Hyperglycemia

2019 ◽  
Vol 58 (19) ◽  
pp. 2825-2830 ◽  
Author(s):  
Naoko Yamamoto ◽  
Yuya Tsurutani ◽  
Sho Katsuragawa ◽  
Haremaru Kubo ◽  
Takashi Sunouchi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Fulminant Type 1 Diabetes ◽  
C Peptide ◽  
Peptide Level ◽  
Fulminant Type

scholarly journals Fulminant Type 1 Diabetes as a Model of Nature to Explore the Role of C-Peptide

2008 ◽  
Vol 2008 ◽  
pp. 1-2
Author(s):  
Yuko Murase-Mishiba ◽  
A. Imagawa ◽  
Toshiaki Hanafusa
Keyword(s):  
Type 1 Diabetes ◽  
Physiological Role ◽  
Chronic Complications ◽  
Fulminant Type 1 Diabetes ◽  
C Peptide ◽  
Onset Of Diabetes ◽  
Fulminant Type

Patients with fulminant type 1 diabetes almost completely lack C-peptide even soon after the onset of the disease, and the deficiency continues for the rest of their life. Thus, fulminant type 1 diabetes could serve as a good model of nature to explore the physiological role of C-peptide. For example, patients with fulminant type 1 diabetes have diabetic chronic complications more frequently than those with classical autoimmune type 1 diabetes 5 years after the onset of diabetes, and the higher prevalence could be partly attributable to the complete lack of C-peptide in fulminant type 1 diabetes.

scholarly journals Immunological Aspects of Fulminant Type 1 Diabetes in Chinese

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Zhen Wang ◽  
Ying Zheng ◽  
Yiting Tu ◽  
Zhijie Dai ◽  
Jian Lin ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Rapid Onset ◽  
Mrna Levels ◽  
Healthy Controls ◽  
Fulminant Type 1 Diabetes ◽  
C Peptide ◽  
Cell Responses ◽  
Qrt Pcr ◽  
Fulminant Type

Background.Fulminant type 1 diabetes (FT1D) is a novel subtype of type 1 diabetes characterized by extremely rapid onset and complete deficiency of insulin due to the destruction of pancreaticβcells. However, the precise mechanisms underlying the etiology of this disease remain unclear.Methods.A total of 22 patients with FT1D and 10 healthy subjects were recruited. Serum antibodies to GAD, IA2, and ZnT8 in patients were tested. And peripheral T cell responses to GAD65, insulin B9–23 peptide, or C peptide were determined in 10 FT1D patients and 10 healthy controls. The mRNA levels of several related cytokines and molecules, such as IFN-γ, IL-4, RORC, and IL-17 in PBMCs from FT1D patients were analyzed by qRT-PCR.Result.We found that a certain proportion of Chinese FT1D patients actually have developed islet-related autoantibodies after onset of the disease. The GAD, insulin, or C peptide-reactive T cells were found in some FT1D patients. We also detected a significant increase for IFN-γexpression in FT1D PBMCs as compared with that of healthy controls.Conclusion.Autoimmune responses might be involved in the pathogenesis of Chinese FT1D.

scholarly journals Distinct Diagnostic Criteria of Fulminant Type 1 Diabetes Based on Serum C-Peptide Response and HbA1c Levels at Onset

Diabetes Care ◽  
2004 ◽  
Vol 27 (8) ◽  
pp. 1936-1941 ◽  
Author(s):  
S. Tanaka ◽  
T. Endo ◽  
K. Aida ◽  
H. Shimura ◽  
N. Yokomori ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diagnostic Criteria ◽  
Fulminant Type 1 Diabetes ◽  
C Peptide ◽  
Fulminant Type ◽  
Hba1c Levels

scholarly journals Detailed Time Course of Decline in Serum C-Peptide Levels in Anti–Programmed Cell Death-1 Therapy–Induced Fulminant Type 1 Diabetes

Diabetes Care ◽  
2019 ◽  
Vol 42 (3) ◽  
pp. e40-e41 ◽  
Author(s):  
Daigo Saito ◽  
Yoichi Oikawa ◽  
Yuya Yano ◽  
Yuichi Ikegami ◽  
Atsushi Satomura ◽  
...  
Keyword(s):  
Cell Death ◽  
Type 1 Diabetes ◽  
Programmed Cell Death ◽  
Time Course ◽  
Fulminant Type 1 Diabetes ◽  
C Peptide ◽  
Programmed Cell Death 1 ◽  
Fulminant Type

Fulminant Type 1 Diabetes Mellitus Associated with Drug Induced Hypersensitivity Syndrome by Zonisamide (Excegran)

2008 ◽  
Vol 70 (5) ◽  
pp. 482-486
Author(s):  
Ikko KAJIHARA ◽  
Asako ICHIHARA ◽  
Jyunko HIGO ◽  
Masato KIDOU ◽  
Mikio TODAKA ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Hypersensitivity Syndrome ◽  
Drug Induced ◽  
Fulminant Type 1 Diabetes ◽  
Fulminant Type

A Case of Fulminant Type 1 Diabetes With Strong Evidence of Autoimmunity

Diabetes Care ◽  
2002 ◽  
Vol 25 (8) ◽  
pp. 1482-1483 ◽  
Author(s):  
A. Shimada ◽  
Y. Oikawa ◽  
T. Shigihara ◽  
T. Senda ◽  
K. Kodama
Keyword(s):  
Type 1 Diabetes ◽  
Strong Evidence ◽  
Fulminant Type 1 Diabetes ◽  
Fulminant Type
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