Checkpointremmer geïnduceerde diabetes mellitus

Background

Checkpoint inhibitors are relatively new anti-cancer medicines that activate tumour cell immunity.

Case description

We describe two patients who presented to the emergency department due to severe ketoacidosis, this being the first symptom of diabetes in said patients. A few weeks prior to this, they each commenced treatment with the checkpoint inhibitor pembrolizumab. HbA1clevel, assessed in one of the patients, was not elevated upon presentation.

Conclusion

Type 1 diabetes mellitus is a rare, but potentially life-threatening, complication of treatment with checkpoint inhibitors. However, routine measurement of glucose or HbA1clevels is not useful in patients who are treated with checkpoint inhibitors. Both patients and healthcare professionals should be (made) aware of the symptoms of hyperglycaemia, thereby ensuring immediate treatment with insulin in order to prevent severe ketoacidosis.

Conflict of interest and financial support: none declared.