Anti-PD‑1-induced type 1 diabetes mellitus in patient with recurrent oropharyngeal squamous cell cancer

Immune checkpoint inhibitors targeting a programmed cell death ligand (PD-L1) have been a major breakthrough in the treatment of many cancers. Nivolumab is an antibody that selectively blocks the PD‑1 receptor on the surface of cytotoxic T-cells to prevent downregulation of the immune response. Immune checkpoint inhibitors can cause immune-related adverse events, including endocrine ones. Type 1 diabetes mellitus is one of the severe rare and potentially lethal immune-related adverse events diagnosed in less than 1% of patients receiving immune checkpoint inhibitors. The total incidence of type 1 diabetes mellitus associated with the PD‑1 inhibitor is relatively low; however, it develops rapidly and is potentially life-threatening without timely diagnosis and treatment. Since PD‑1 inhibitors are widely used in cancer treatment, complications such as type 1 diabetes mellitus should attract medical attention. During treatment, specialists should help patients better recognize the symptoms of hyperglycemia or diabetic ketoacidosis, which requires careful observation, regular monitoring of blood glucose levels, rapid detection and correct diagnosis and treatment of diabetes mellitus. 

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