{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T14:46:09Z","timestamp":1791211569347,"version":"4.1.0"},"reference-count":26,"publisher":"The Endocrine Society","issue":"5","license":[{"start":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T00:00:00Z","timestamp":1700784000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To conduct a multicenter case series characterizing the clinical characteristics at presentation and pancreatic volume changes of patients with checkpoint inhibitor-associated autoimmune diabetes (CIADM).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Research Design and Methods<\/jats:title>\n                  <jats:p>Electronic medical records were reviewed with 36 consecutive patients identified with CIADM, as defined by (1) previous immune checkpoint inhibitor (ICI) therapy, (2) new-onset hyperglycemia (blood glucose level \u2265 11.1\u2005mmol\/L and\/or glycosylated hemoglobin \u2265 6.5%), and (3) insulin deficiency [C-peptide &amp;lt;0.4\u2005nmol\/L or diabetic ketoacidosis (DKA)] within 1 month of presentation. Pancreatic volume was available and measured using computed tomography volumetry for 17 patients with CIADM and 3 sets of control patients: 7 with ICI-related pancreatitis, 13 with asymptomatic ICI-related lipase elevation, and 11 ICI-treated controls for comparison.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>All patients had either anti-programmed cell death protein 1 or anti-programmed cell death ligand 1 therapy. Median time from ICI commencement to CIADM diagnosis was 15 weeks. At presentation, 25 (69%) had DKA, 27 (84%) had low C-peptide, and, by 1 month, 100% had low C-peptide. Traditional type 1 diabetes autoantibodies were positive in 15\/35 (43%). Lipase was elevated in 13\/27 (48%) at presentation. In 4 patients with longitudinal lipase testing, elevated levels peaked 1 month prior to CIADM diagnosis. Pancreatic volume was lower pre-ICI in CIADM patients compared with controls and demonstrated a mean decline of 41% from pretreatment to 6 months post-CIADM diagnosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Pronounced biochemical and radiologic changes occur during CIADM pathogenesis. Rapid loss of C-peptide is a distinct characteristic that can be used to aid diagnosis as autoantibodies are often negative.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgad685","type":"journal-article","created":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T10:54:20Z","timestamp":1700823260000},"page":"1301-1307","source":"Crossref","is-referenced-by-count":24,"title":["Checkpoint Inhibitor-Associated Autoimmune Diabetes Mellitus Is Characterized by C-peptide Loss and Pancreatic Atrophy"],"prefix":"10.1210","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8699-6341","authenticated-orcid":false,"given":"Linda","family":"Wu","sequence":"first","affiliation":[{"name":"Westmead Institute for Medical Research, Centre for Diabetes and Endocrinology, Westmead 2145, NSW, Australia"},{"name":"Department of Endocrinology, Westmead Hospital, Westmead 2145, NSW, Australia"},{"name":"Faculty of Medicine and Health, The University of Sydney, Camperdown 2050, NSW, Australia"},{"name":"Melanoma Institute Australia, The University of Sydney, Wollstonecraft 2065, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo Salvatore","family":"Carlino","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, The University of Sydney, Camperdown 2050, NSW, Australia"},{"name":"Melanoma Institute Australia, The University of Sydney, Wollstonecraft 2065, NSW, Australia"},{"name":"Department of Oncology, Westmead Hospital, Westmead 2145, NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Alexander","family":"Brown","sequence":"additional","affiliation":[{"name":"Westmead Institute for Medical Research, Centre for Diabetes and Endocrinology, Westmead 2145, NSW, Australia"},{"name":"Faculty of Medicine and Health, The University of Sydney, Camperdown 2050, NSW, Australia"},{"name":"Institute of Clinical Pathology and Medical Research, Department of Immunology, 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