A Case of Type 2 Diabetes Mellitus with Lung Cancer Suffered from Euglycemic Diabetic Ketosis Accompanied by Adrenal Insufficiency after Immune Checkpoint Inhibitors

A 74-year-old patient with type 2 diabetes mellitus received basal-bolus insulin, insulin secretagogues, and sodium glucose transporter 2 (SGLT2) inhibitors. After immune checkpoint inhibitor treatment for lung cancer, he suffered from depressed consciousness with a urinary ketone body (3+). When al...

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Bibliographic Details
Published in:Case reports in endocrinology 2024-02, Vol.2024, p.9982174-5
Main Authors: Shibasaki, Saeko, Noda, Chisei, Imagawa, Akihisa, Sakane, Sadaki
Format: Article
Language:English
Subjects:
Acids
ACTH
Antibodies
Apoptosis
Blood sugar
Blood tests
Cancer patients
Carbohydrates
Care and treatment
Case Report
Case reports
Complications and side effects
Diabetes
Diabetes therapy
Diabetic ketoacidosis
Drug approval
Emergency medical care
Glucose
Growth hormones
Hypoglycemia
Insulin
Insulin-like growth factors
Ipilimumab
Ketosis
Lung cancer
Lung cancer, Non-small cell
Metabolic disorders
Patients
Peptides
Respiratory agents
Side effects
Thyroid gland
Type 1 diabetes
Type 2 diabetes
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Summary:A 74-year-old patient with type 2 diabetes mellitus received basal-bolus insulin, insulin secretagogues, and sodium glucose transporter 2 (SGLT2) inhibitors. After immune checkpoint inhibitor treatment for lung cancer, he suffered from depressed consciousness with a urinary ketone body (3+). When all hypoglycemic treatments were discontinued, his serum blood glucose remained at 121 mg/dL. He was diagnosed with euglycemic diabetic ketosis. Endocrine loading tests revealed isolated adrenocorticotropic hormone (ACTH) deficiency as an immune-related adverse event. It was suggested that euglycemic diabetic ketosis was induced by the self-suspension of insulin and insulin secretagogues, adrenal insufficiency, SGLT2 inhibitors, and carbohydrate intake shortage.
ISSN:2090-6501
2090-651X
DOI:10.1155/2024/9982174