endocrinopathy induced diabetes mellitus pdf - Keywords cancer diabetes endocrinopathy glucocorticoids hypophysitis bolehkah penderita diabetes makan sate ayam immunotherapy thyroiditis Introduction Immunotherapy with immune checkpoint inhibitors ICIs has transformed the treatment of cancer by harnessing the power of the immune system Results Immunotherapy with ICIs has transformed the treatment landscape of diverse types of cancers but frequently results in immunemediated endocrinopathies that can cause acute and persistent morbidity and rarely death Diabetes Mellitus Secondary to Endocrine Diseases An Update Immune checkpoint inhibitorinduced diabetes mellitus with Endocrinerelated adverse events associated with immune American Association of Clinical Endocrinology Disease State Importantly irAEs can manifest as endocrinopathies involving the thyroid hypothyroidism or thyrotoxicosis pituitary hypophysitis adrenal glands adrenal insufficiency and pancreas How is ICIInduced Diabetes Mellitus Managed Because of the acute onset and risk of DKA in patients with ICIinduced DM early diagnosis and prompt treatment with insulin are important to decrease mortality and improve prognosis Endocrinerelated adverse conditions in patients receiving The aim of this report is to highlight the importance of recognising ICIinduced DM as a rare immunerelated adverse event in patients receiving programmed cell death protein 1programmed cell death proteinligand 1 inhibitor therapy and provide clinicians with insight into immune checkpoint endocrinopathies with an emphasis on diabetes and DKA The following endocrine adverse conditions related to ICI treatment were considered hypophysitis thyroid disorders Graves39 disease thyroiditis hypothyroidism thyroid eye disease adrenal insufficiency diabetes mellitus hypoparathyroidism and polyendocrine syndromes Endocrinopathies from checkpoint inhibitors Incidence Reaching the Diagnosis of Checkpoint InhibitorInduced Pancreatic endocrine dysfunction diabetes mellitus The adverse effects of immune checkpoint inhibitor therapy on pancreatic endocrine function manifest in a similar manner to type 1 diabetes mellitus with low or undetectable Cpeptide and elevated autoantibody levels 1438 Endocrinopathies are some of the most frequently reported adverse effects and thyroid dysfunction is the most common of these Here we review the incidence and severity of each immune checkpoint inhibitorrelated endocrinopathy possible factors related to toxicity risk and principles of management In a recent systematic review Wu et al 7 updated the diagnostic criteria for CPIDM as follows i evidence of newonset hyperglycemia postCPI treatment in the diabetes range according to the classical American Diabetes Association criteria random blood glucose 111 mmolL or HbA1c 65 18 and ii insulin deficiency determined b Diabetes mellitus secondary to endocrine diseases is generally characterized by mild signs and symptoms with hyperglycemia that is most often reversible after the therapy of the underlying disease The importance of screening apakah kentang rebus baik untuk diabetes for diabetes in endocrine diseases lies in the fact that diabetes increases the risk for cardiovascular mortality and Critical Overview on Endocrine Disruptors in Diabetes Mellitus Charlotte Hinault 1 Université Côte dAzur INSERM U1065 C3M Bâtiment Universitaire Archimed 151 Route de SaintAntoine de Ginestière BP 2 3194 CEDEX 3 06204 Nice France 2 Équipe Labelisée Ligue Nationale Contre le Cancer Pathophysiology diagnosis and management of immune American Association of Clinical Endocrinology Disease State Immunotherapyinduced endocrinopathies assessment Immune checkpoint inhibitors an emerging cause of insulin induced diabetes mellitus ICIDM is one such endocrinopathy and has particular clinical significance as the majority of patients present in diabetic ketoacidosis DKA and require lifelong treatment with insulin therapy2 ICIDM has been reported with PD1 and PDL1 inhibitors and rarely with CTLA 4 inhibitors 2 3 Diabetes mellitus DM is a rare endocrinopathy induced by ICI but as it may turn out lifethreatening if manifests as diabetic ketoacidosis DKA it demands careful clinical consideration 2 The likelihood of ICIinduced diabetes mellitus ICIDM varies depending on the ICI Immune Checkpoint Inhibitorrelated Endocrinopathies PMC Endocrinopathies from checkpoint inhibitors Incidence Our scoping study uncovers a wider spectrum of ICIinduced endocrinopathies 222 hypopituitarism 152 thyroid disorders 66 diabetes mellitus 6 primary adrenal insufficiency 1 pituitary ACTHdependent Cushings syndrome 1 hypoparathyroidism and 3 diabetes insipidus cases Fig 3 Immune checkpoint inhibitorinduced diabetes mellitus with Endocrine toxicities of immune checkpoint inhibitors Nature Critical Overview on Endocrine Disruptors in Diabetes Mellitus Immune checkpoint inhibitorinduced diabetes mellitus ICIDM has increasingly been reported with prevalence up to 2 and the majority of patients present in diabetic ketoacidosis and require lifelong insulin therapy Among the 1163 patients treated with a PD1 inhibitor 21 18 17 on pembrolizumab and 4 on nivolumab met criteria for ICIinduced diabetes of which 12 1 had newonset insulindependent diabetes and 9 08 experienced worsening of preexisting type 2 diabetes Spectrum of immune checkpoint inhibitorsinduced Immune checkpoint inhibitorinduced diabetes mellitus with ICIrelated thyroid dysfunction ICITD is the leading subtype and hypophysitis is ranked second these are followed by ICIrelated insulindeficient diabetes mellitus DM primary adrenal insufficiency PAI and autoimmune polyendocrine syndrome APS which have been described in several case reports 3 Caroline Robert h Show more Add to Mendeley httpsdoiorg101016jctrv201706002 Get rights and content Under a Creative Commons license open access Highgrade immunerelated endocrinopathies occur in 12 of patients Can affect thyroid pituitary adrenal 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