免疫检查点抑制剂相关性糖尿病的研究进展

A review of immune checkpoint inhibitor-associated diabetes mellitus

随着肿瘤免疫治疗的不断发展,免疫检查点抑制剂相关性糖尿病患者逐渐增多,并主要以糖尿病急性并发症即糖尿病酮症酸中毒为首发症状出现,患者疾病发展迅速,病情危重;对临床医生而言,尽早识别及诊治使用免疫检查点抑制剂后出现糖尿病急性并发症的患者非常重要。该文概述了免疫检查点抑制剂相关性糖尿病的临床特点、流行病学、病理机制、诊治方法及患者管理,以期为临床医生提供帮助,提高临床医生对该病的认识和警惕性。

With the continuous development of tumor immunotherapy,immune checkpoint inhibitor-associated diabetes mellitus is gradually increasing,mainly with acute complications of diabetes mellitus.For example,diabetic ketoacidosis is the first symptom of the emergence of the patient′s rapid disease progression,and the condition of the patient is critical.For clinicians,early identification,diagnosis,and treatment are particularly important,and at the same time,it is also important to identify patients who are prone to acute complications of diabetes after the use of immune checkpoint inhibitors.This review outlines the clinical features,epidemiology,pathomechanisms,diagnostic and treatment methods,and management of immune checkpoint inhibitor-associated diabetes mellitus,with the hope of assisting clinicians and increasing their awareness and vigilance of immune checkpoint inhibitor-associated diabetes mellitus.