This paper summarized the nursing experience of 5 patients with fulminant type 1 diabetic ketoacidosis caused by immune checkpoint inhibitors. In view of the characteristics of acute onset and critical condition of fulminant type 1 diabetic ketoacidosis caused by immune checkpoint inhibitors,we adopted fluid rehydration,correction of water,electrolyte and acid-base balance,standardized insulin therapy and use of insulin pump,blood glucose monitoring during hospitalization and application of immune checkpoint inhibitors,continuous care after discharge and early identification of ketoacidosis. After careful treatment and other nursing measures,5 patients had stable blood glucose control,were recovered and discharged. Regular follow-up showed no recurrence of related complications.
LÜ Suzhen
,
WEI Yueqiu
,
CHEN Kai
,
LI Lifen
,
FENG Xiaohong
. Nursing care of 5 cases of fulminant type 1 diabetic ketoacidosis caused by immune checkpoint inhibitors[J]. Chinese Journal of Emergency and Critical Care Nursing, 2023
, 4(3)
: 252
-254
.
DOI: 10.3761/j.issn.2096-7446.2023.03.012
[1] HargAdon KM,Johnson CE,Williams CJ. Immune checkpoint blo-ckade therapy for cancer:an overview of FDA-approved immune checkpoint inhibitors[J]. Int Immunopharmacol,2018,62:29-39.
[2] 吴绮楠,童南伟. 《肿瘤相关性高血糖管理指南(2021年版)》解读[J]. 中国癌症杂志,2021,31(12):1153-1161.
Wu QN,Tong NW.Interpretation of guidelines for the management of tumor-associated hyperglycemia(2021 edition)[J]. China Oncol,2021,31(12):1153-1161.
[3] 张瑞,刘柳,蔡晓凌,等. 免疫检查点抑制剂治疗后发生1型糖尿病二例报道并文献综述[J]. 中国糖尿病杂志,2020,28(1):62-70.
Zhang R,Liu L,Cai XL,et al.Two case reports of immune checkpoint inhibitors induced type 1 diabetes and literature review[J]. Chin J Diabetes,2020,28(1):62-70.
[4] Imagawa A,Hanafusa T,Awata T,et al.Report of the Committee of the Japan Diabetes Society on the research of fulminant and acute-onset type 1 diabetes mellitus:new diagnostic criteria of fulminant type 1 diabetes mellitus(2012)[J]. J Diabetes Investig,2012,3(6):536-539.
[5] 陈优飞. 免疫检查点抑制剂致暴发性1型糖尿病合并酮症酸中毒三例[J]. 实用肿瘤杂志,2021,36(5):458-461.
Chen YF.Three cases of fulminant type 1 diabetes mellitus with ketoacidosis caused by immune checkpoint inhibitors[J]. J Pract Oncol,2021,36(5):458-461.
[6] 中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2020年版)[J]. 中华糖尿病杂志,2021,13(4):315-409.
Diabetes Branch of Chinese Medical Association. Guideline for the prevention and treatment of type 2 diabetes mellitus in China(2020 edition)[J]. Chin J Diabetes Mellitus,2021,13(4):315-409.
[7] 张星,高玲玲,郭晓迪,等. 11例糖尿病酮症酸中毒昏迷患者合并重症急性胰腺炎的护理[J]. 中华护理杂志,2020,55(11):1701-1705.
Zhang X,Gao LL,Guo XD,et al.Nursing care of 11 patients with severe acute pancreatitis and diabetic coma caused by diabetic ketoacidosis[J]. Chin J Nurs,2020,55(11):1701-1705.
[8] 姜林,黄薇. 免疫检查点抑制剂应用后发生糖尿病一例报道[J]. 中华糖尿病杂志,2021(12):1174-1176.
Jiang L,Huang W.A case of diabetes mellitus after the application of immune checkpoint inhibitors was reported[J]. Chin J Diabetes Mullitus,2021(12):1174-1176.
[9] Yim C,Mansell K,Hussein N,et al.Current cancer therapies and their influence on glucose control[J]. World J Diabetes,2021,12(7):1010-1025.
[10] ARIMA H,Iwama S,Inaba H,et al.Management of immune-related adverse events in endocrine organs induced by immune checkpoint inhibitors:clinical guidelines of the Japan Endocrine Society[J]. Endocr J,2019,66(7):581-586.
[11] 施云,沈敏,顾愹,等. 免疫检查点抑制剂相关1型糖尿病[J]. 中华糖尿病杂志,2020,12(12):945-948.
Shi Y,Shen M,Gu Y,et al.Immune checkpoint inhibitor-induced type 1 diabetes mellitus[J]. Chin J Diabetes Mellit,2020, 12(12):945-948.
[12] 任尧尧,张琳琳,王瑜,等. 免疫检查点抑制剂相关糖尿病2例报道及文献回顾[J]. 中国肺癌杂志,2022,25(1):61-65.
Ren YY,Zhang LL,Wang Y,et al.Immune checkpoint inhibitors related diabetes mellitus:a report of 2 cases and literature review[J]. Chin J Lung Cancer,2022,25(1):61-65.