Related Experiment Video
Updated: May 27, 2026
Murine Model of Leukemia Relapse to Induction Chemotherapy for Acute Lymphoblastic Leukemia
Published on: October 17, 2025
Medication induced diabetes during induction in pediatric acute lymphoblastic leukemia: prevalence, risk factors and
Dror Koltin1, Lillian Sung, Ahmed Naqvi
1The Division of Endocrinology, The Hospital for Sick Children, Toronto, Canada. dror.koltin@sickkids.ca
Introduction:
Medication induced diabetes (MID) during induction therapy (MIDi) in patients with acute lymphoblastic leukemia (ALL) is not well characterized in children, with recent studies yielding conflicting results.
Purpose:
The purpose of the study was to describe the prevalence of MIDi and risk factors for its development.
Methods:
We retrospectively gathered demographic, disease course and treatment data on 363 patients aged 1 to 17.9 years diagnosed with ALL at a pediatric tertiary care hospital between 1998 and 2005. MIDi was defined as blood glucose ≥200 mg/dL (11.1 mmol/L) on at least 2 separate days during induction.
Results:
Fifty-seven subjects (15.7%) developed MIDi during the study period. Patients ≥10 years were more likely to develop MIDi than those <10 years (odds ratio [OR] 9.6, 95% confidence interval [CI] 5.1-17.8). BMI percentile among those with MIDi (mean ± SD 58.2 ± 31.0) did not differ from those without MIDi (52.2 ± 32.0, P = 0.429). The presence of Trisomy 21 (OR 3.6, 95% CI 1.1-11.4, P = 0.030) and CNS involvement at diagnosis (OR 3.8, 95% CI 1.4-10.1, P = 0.009) were associated with an increased risk of MIDi. After adjustment for potential confounding variables, age ≥10 years and the presence of CNS disease at diagnosis remained significantly associated with MIDi.
Conclusions:
Older age and CNS involvement at diagnosis increase the risk of MIDi. In contrast to previous studies, higher BMI was not associated with MIDi in our population.
Insights
Older children with acute lymphoblastic leukemia (ALL) and central nervous system (CNS) involvement at diagnosis face a higher risk of medication-induced diabetes (MID) during induction therapy. Higher BMI was not found to be a risk factor in this study.
Area of Science:
- Pediatric Oncology
- Endocrinology
- Clinical Research
Background:
- Medication-induced diabetes (MID) during induction therapy (MIDi) in pediatric acute lymphoblastic leukemia (ALL) patients is not well understood.
- Conflicting results exist regarding risk factors, necessitating further characterization.
Purpose of the Study:
- To determine the prevalence of MIDi in children with ALL.
- To identify risk factors associated with the development of MIDi.
Main Methods:
- Retrospective analysis of 363 pediatric ALL patients (aged 1-17.9 years) diagnosed between 1998-2005.
- MIDi defined as blood glucose ≥200 mg/dL on at least two separate days during induction therapy.
- Demographic, disease course, and treatment data were collected.
Main Results:
- The prevalence of MIDi was 15.7% (57 out of 363 patients).
- Patients aged ≥10 years had a significantly higher risk (OR 9.6).
- Trisomy 21 (OR 3.6) and CNS involvement at diagnosis (OR 3.8) were associated with increased MIDi risk. Age ≥10 and CNS disease remained significant after adjustment.
Conclusions:
- Older age and CNS involvement at diagnosis are significant risk factors for MIDi in pediatric ALL.
- Unlike some prior studies, elevated BMI was not associated with MIDi in this cohort.
Related Concept Videos
01:12Type I Diabetes I: Introduction
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
01:22Diabetes Mellitus: Overview and Type I Subtype
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...