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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Main Authors: Saeko Shibasaki, Chisei Noda, Akihisa Imagawa, Sadaki Sakane
Format: Article
Language:English
Published: Wiley 2024-01-01
Series:Case Reports in Endocrinology
Online Access:http://dx.doi.org/10.1155/2024/9982174
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author Saeko Shibasaki
Chisei Noda
Akihisa Imagawa
Sadaki Sakane
author_facet Saeko Shibasaki
Chisei Noda
Akihisa Imagawa
Sadaki Sakane
author_sort Saeko Shibasaki
collection DOAJ
description 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.
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publishDate 2024-01-01
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series Case Reports in Endocrinology
spelling doaj-art-8e93eecf4b554dfd8b866cf6b64eccff2025-08-20T02:09:23ZengWileyCase Reports in Endocrinology2090-651X2024-01-01202410.1155/2024/9982174A Case of Type 2 Diabetes Mellitus with Lung Cancer Suffered from Euglycemic Diabetic Ketosis Accompanied by Adrenal Insufficiency after Immune Checkpoint InhibitorsSaeko Shibasaki0Chisei Noda1Akihisa Imagawa2Sadaki Sakane3Department of Internal Medicine (Diabetes and Endocrinology)Department of Internal Medicine (Diabetes and Endocrinology)Department of Internal Medicine (I)Department of Internal Medicine (Diabetes and Endocrinology)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.http://dx.doi.org/10.1155/2024/9982174
spellingShingle Saeko Shibasaki
Chisei Noda
Akihisa Imagawa
Sadaki Sakane
A Case of Type 2 Diabetes Mellitus with Lung Cancer Suffered from Euglycemic Diabetic Ketosis Accompanied by Adrenal Insufficiency after Immune Checkpoint Inhibitors
Case Reports in Endocrinology
title A Case of Type 2 Diabetes Mellitus with Lung Cancer Suffered from Euglycemic Diabetic Ketosis Accompanied by Adrenal Insufficiency after Immune Checkpoint Inhibitors
title_full A Case of Type 2 Diabetes Mellitus with Lung Cancer Suffered from Euglycemic Diabetic Ketosis Accompanied by Adrenal Insufficiency after Immune Checkpoint Inhibitors
title_fullStr A Case of Type 2 Diabetes Mellitus with Lung Cancer Suffered from Euglycemic Diabetic Ketosis Accompanied by Adrenal Insufficiency after Immune Checkpoint Inhibitors
title_full_unstemmed A Case of Type 2 Diabetes Mellitus with Lung Cancer Suffered from Euglycemic Diabetic Ketosis Accompanied by Adrenal Insufficiency after Immune Checkpoint Inhibitors
title_short A Case of Type 2 Diabetes Mellitus with Lung Cancer Suffered from Euglycemic Diabetic Ketosis Accompanied by Adrenal Insufficiency after Immune Checkpoint Inhibitors
title_sort case of type 2 diabetes mellitus with lung cancer suffered from euglycemic diabetic ketosis accompanied by adrenal insufficiency after immune checkpoint inhibitors
url http://dx.doi.org/10.1155/2024/9982174
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