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Table 1 Clinical and biochemical data at diabetes onset in our index cases and cases reported in the literature

From: Combined immune checkpoint inhibitor therapy with nivolumab and ipilimumab causing acute-onset type 1 diabetes mellitus following a single administration: two case reports

 Case n° 1Case n° 2Changizzadeh et al. [9]Gunawan et al. [10]Lowe et al. [11]
Age (years) / Gender60/M80/F42/M52/M54/M
History of diabetesT2DMNoNoNoNo
Familial history of diabetesNoNoNoNRNR
NeoplasiaMelanoma stage IVMelanoma stage IVMelanoma stage IVMelanoma stage IVMelanoma stage IV
Prior corticosteroid administrationNoNoNoYesaYesb
ICI regimenIPI (3 mg/kg) and NIVO (1 mg/kg) every 3 weeksIPI (3 mg/kg) and NIVO (1 mg/kg) every 3 weeksIPI (3 mg/kg) and NIVO (1 mg/kg) every 3 weeksIPI (3 mg/kg) and NIVO (1 mg/kg) every 3 weeksIPI (3 mg/kg) and NIVO (1 mg/kg) every 3 weeks
Time to T1DM onset2 weeks (1 cycle)5 weeks (1 cycle)12 weeks (3 cycles)11 weeks (3 cycles)19 weeks (3 cycles)
DKAYesYesYesNoYes
Plasma glucose (mmol/L)4648.440.420.8NR
Ketones bodies (mmol/L)
 PlasmaNANANR2.4NR
 Urine> 7.8> 7.8NRNR0.40
HbA1C (%)7.5NA6.57.7NR
C-Peptide (nmol/L)NANANR0.05 (N: 0.4–1.5)NR
T1DM-related autoantibodies+ (GADA, ICA, IA2)+ (GADA, ICA) IA2 -- (GADA, IA2, ZnT8A)- (GADA, IA2, ZnT8A)(GADA)
Other immune-related endocrine toxicitiesNoneAutoimmune thyroiditisNoneHypophysitis, Diabetes insipidusAutoimmune thyroiditis Hypophysitis
Non endocrine immune related toxicitiesPresumed immune-checkpoint inhibitor-induced pancreatic injuryNoneColitisNoneHepatitis, Colitis
Definitive discontinuation of ICIYesYesYesYesYes
  1. aIndication: autoimmune hypophysitis; Dexamethasone 8 mg twice a day for 24 h and then hydrocortisone 30 mg/day were started five weeks before T1DM onset. bIndication: autoimmune hepatitis and colitis; Prednisone was started ten weeks before T1DM and discontinued before T1DM onset. Abbreviations: M Male, F Female, ICI Immune checkpoint inhibitors, IPI Ipilimumab, NIVO Nivolumab, W Week; T2DM Type 2 diabetes mellitus, T1DM Type 1 diabetes mellitus, NA Not analysed, NR Not reported