Evidence map›Paper›PMID 41044787›Full record

ArticleDiabetology & metabolic syndrome2025

Immune checkpoint inhibitor therapy and risk of type 1 diabetes mellitus in metastatic cancer patients.

Ming-Hsun Lin, Ren-Hua Ye, Hong-Jie Jhou, Hsin-Yu Chen, Li-Ting Kao, Tina Yi-Jin Hsieh, Yu-Han Chen, Andrea Yue-En Sun, Xiaoyi Zhang, Ming-Shen Dai and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetology & metabolic syndrome, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Ming-Hsun LinDivision of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan.
Ren-Hua YeDivision of Hematology and Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan.
Hong-Jie JhouNeurological Institute, Changhua Christian Hospital, Changhua, Taiwan.
Hsin-Yu ChenDepartment of Family Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Li-Ting KaoGraduate Institute of Life Sciences, National Defense Medical University, Taipei, Taiwan.
Tina Yi-Jin HsiehDepartment of Obstetrics & Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Yu-Han ChenDepartment of Internal Medicine, Englewood Hospital and Medical Center, Englewood, NJ, USA.
Andrea Yue-En SunCollege of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Xiaoyi ZhangDepartment of Internal Medicine, NYC Health + Hospitals/Jacobi, Albert Einstein College of Medicine, Bronx, NY, USA.
Ming-Shen DaiDivision of Hematology and Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan.
Ching-Liang HoDivision of Hematology and Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan.
Po-Huang Chen *Division of Hematology and Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan. chenpohuang@hotmail.com.
Cho-Hao Lee *Division of Hematology and Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical University, Taipei, Taiwan. drleechohao@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsTo assess the risk of new-onset type 1 diabetes mellitus (T1DM) and diabetic ketoacidosis (DKA) in metastatic cancer patients treated with immune checkpoint inhibitors (ICIs) compared to those receiving non-ICI therapies.

methodA retrospective cohort study using TriNetX global electronic health records (2014-2025) from multiple healthcare systems. Adult metastatic cancer patients initiating ICI or non-ICI therapy were included. Patients with preexisting diabetes within 6 months were excluded. After 1:1 propensity score matching, 25,463 patients remained in each group. Outcomes were identified by ICD-10 codes.

resultsMedian follow-up was 764 days (ICI) vs. 692 days (non-ICI). ICI use was associated with a higher risk of T1DM (HR, 2.35; 95% CI, 1.81-3.04) and DKA (HR, 10.58; 95% CI, 4.21-26.59). Cumulative incidence analyses supported these findings, with ICIs showing higher risks of T1DM (0.75% vs. 0.32%; RR, 2.32 [95% CI, 1.79-3.00]) and DKA (0.20% vs. 0.04%; RR, 5.00 [95% CI, 2.54-9.86]). Subgroup analyses identified elevated baseline HbA1c (> 6.0%), male sex, white race, and dual checkpoint blockade as high-risk factors.

conclusionICIs significantly increase the risk of T1DM and DKA. These findings highlight the need for vigilant glycemic monitoring in cancer patients treated with ICIs, especially within identified high-risk subgroups.

Indexed as

Cancer immunotherapyDiabetic ketoacidosisImmune checkpoint inhibitorsImmune-Related adverse eventsPropensity score matchingType 1 diabetes

Identifiers

PMID41044787
PMCPMC12495861

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.