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Acta Diabetologica

, Volume 56, Issue 4, pp 489–490 | Cite as

Nivolumab-induced fulminant type 1 diabetes (T1D): the first Italian case report with long follow-up and flash glucose monitoring

  • Francesco TassoneEmail author
  • Ida Colantonio
  • Elena Gamarra
  • Laura Gianotti
  • Claudia Baffoni
  • Giampaolo Magro
  • Giorgio Borretta
Letter to the Editor
  • 165 Downloads

Nivolumab, an Immune Checkpoint Inhibitor (ICI) against programmed death-1 receptors expressed on T-lymphocytes, has been approved by the Food and Drug Administration (FDA) for the treatment of multiple cancers such as Non-squamous Cell Lung Cancer [1]. There are some concerns on this class of ICIs about immune-related adverse events, including thyroid dysfunction, hypophysitis, adrenal insufficiency and autoimmune diabetes mellitus (DM) [1].

Fulminant DM is a clinical entity firstly described in Japan, mainly characterized by markedly rapid onset of hyperglycemia with ketoacidosis, near normal glycated hemoglobin (HbA1c) levels despite remarkable hyperglycemia. Peculiar genetic factors, including human leukocyte antigen genes, are associated with the development of this subtype of diabetes and this could be the reason of the more frequent presentation of these cases in Asian populations. The Japanese Diabetes association has provided criteria for the diagnosis of this form of DM [2].

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Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Human and animal rights disclosure

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from the patient.

References

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    Imagawa A, Hanafusa T, Awata T et al (2012) Report of the Committee of the Japan Diabetes Society on the Research of Fulminant and Acute-onset Type 1 diabetes mellitus: new diagnostic criteria of fulminant type 1 diabetes mellitus. J Diabetes Investig 3(6):536–539 (PubMed PMID: 24843620) CrossRefPubMedPubMedCentralGoogle Scholar
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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  • Francesco Tassone
    • 1
    Email author
  • Ida Colantonio
    • 2
  • Elena Gamarra
    • 1
  • Laura Gianotti
    • 1
  • Claudia Baffoni
    • 1
  • Giampaolo Magro
    • 1
  • Giorgio Borretta
    • 1
  1. 1.Division of Endocrinology, Diabetes & MetabolismSanta Croce e Carle HospitalCuneoItaly
  2. 2.Division of OncologySanta Croce e Carle HospitalCuneoItaly

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