Unravelling Checkpoint Inhibitor Associated Autoimmune Diabetes: From Bench to Bedside

Front Endocrinol (Lausanne). 2021 Nov 5:12:764138. doi: 10.3389/fendo.2021.764138. eCollection 2021.


Immune checkpoint inhibitors have transformed the landscape of oncological therapy, but at the price of a new array of immune related adverse events. Among these is β-cell failure, leading to checkpoint inhibitor-related autoimmune diabetes (CIADM) which entails substantial long-term morbidity. As our understanding of this novel disease grows, parallels and differences between CIADM and classic type 1 diabetes (T1D) may provide insights into the development of diabetes and identify novel potential therapeutic strategies. In this review, we outline the knowledge across the disciplines of endocrinology, oncology and immunology regarding the pathogenesis of CIADM and identify possible management strategies.

Keywords: diabetes mellitus; immune checkpoint inhibitor (ICI); immune related adverse events; immunotherapy; type 1 diabetes.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antineoplastic Agents, Immunological / adverse effects
  • Antineoplastic Agents, Immunological / immunology
  • Diabetes Mellitus, Type 1 / blood*
  • Diabetes Mellitus, Type 1 / chemically induced*
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 1 / immunology
  • Humans
  • Hyperglycemia / blood
  • Hyperglycemia / chemically induced
  • Hyperglycemia / drug therapy
  • Hyperglycemia / immunology
  • Immune Checkpoint Inhibitors / adverse effects*
  • Immune Checkpoint Inhibitors / immunology
  • Insulin / blood
  • Insulin / immunology
  • Insulin / therapeutic use
  • Risk Factors


  • Antineoplastic Agents, Immunological
  • Immune Checkpoint Inhibitors
  • Insulin