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A case of doxorubicin and cyclophosphamide therapy-induced type 1 diabetes: a case report

Makoto Miyabayashi1, Shunichiro Onishi1,2, Tomohiko Yoshida1,2

  • 1International University of Health and Welfare, Narita Hospital, 852 Hatakeda, Narita City, Chiba, 286-8520, Japan.

Journal of Medical Case Reports
|January 26, 2023
PubMed
Abstract

Insights

Chemotherapy drugs doxorubicin and cyclophosphamide rarely induce type 1 diabetes. This case highlights the need for careful patient monitoring during cancer treatment for unexpected autoimmune responses.

Area of Science:

  • Endocrinology
  • Oncology
  • Immunology

Background:

  • Immune checkpoint inhibitors can cause autoimmune endocrine diseases like type 1 diabetes.
  • Other drugs, besides immune checkpoint inhibitors, may also induce type 1 diabetes.
  • Type 1 diabetes development is a rare but serious adverse effect of certain medical treatments.

Observation:

  • A 54-year-old female patient developed severe hyperglycemia (1661 mg/dL) and diabetic ketoacidosis (pH 7.120) after three cycles of doxorubicin and cyclophosphamide chemotherapy for breast cancer.
  • The patient exhibited impaired insulin secretion and significantly positive anti-glutamic acid decarboxylase antibodies.
  • This presentation suggests an autoimmune etiology for the induced diabetes.

Findings:

  • Doxorubicin and cyclophosphamide therapy can rarely lead to the sudden onset of type 1 diabetes.
  • This is the first reported case of type 1 diabetes developing after doxorubicin and cyclophosphamide treatment.
  • The patient's condition indicates a potential drug-induced autoimmune response targeting insulin production.

Implications:

  • Oncologists and endocrinologists should be aware of the potential for chemotherapy-induced type 1 diabetes.
  • Close monitoring of blood glucose and early detection of diabetes symptoms are crucial in patients receiving doxorubicin and cyclophosphamide.
  • Further research is needed to understand the mechanisms and incidence of drug-induced type 1 diabetes.
Keywords:
CyclophosphamideDoxorubicinType 1 diabetes

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