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Published on: June 11, 2012

Hyperglycemia during ICI Therapy: etiology, risk factors, and survival outcome

Min Shen1, Xinpan Wang1, Tianyu Gao1

  • 1Department of Endocrinology and Metabolism, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.

Journal of Endocrinological Investigation
|August 13, 2026
PubMed
Abstract

Insights

Hyperglycemia during immune checkpoint inhibitor (ICI) therapy is common, with steroid use and pre-existing diabetes as key risk factors. However, glycemic status did not significantly impact overall survival in patients receiving ICIs.

Area of Science:

  • Oncology
  • Endocrinology
  • Immunotherapy

Background:

  • The impact of hyperglycemia on overall survival (OS) in patients undergoing immune checkpoint inhibitor (ICI) therapy remains unclear.
  • Understanding the spectrum of hyperglycemia and its association with outcomes is crucial for managing patients on ICIs.

Purpose of the Study:

  • To characterize hyperglycemia in patients receiving PD-1 or PD-L1 inhibitors.
  • To identify risk factors for hyperglycemia during ICI treatment.
  • To evaluate the association between glycemic status and OS in this patient population.

Main Methods:

  • Retrospective analysis of 2,836 patients treated with PD-1 or PD-L1 inhibitors.
  • Assessment of hyperglycemia characteristics and etiologies.
  • Multivariable Cox regression and propensity score matching (PSM) to analyze OS.

Main Results:

  • 24.33% of patients experienced hyperglycemia during ICI therapy.
  • Key risk factors for hyperglycemia included pre-existing diabetes, digestive system tumors, supraphysiologic steroid use, and baseline fasting blood glucose (FBG).
  • No significant association was found between glycemic status and OS, nor did ICI-induced type 1 diabetes (ICI-T1DM) independently affect survival.

Conclusions:

  • Hyperglycemia during ICI therapy can stem from various causes, necessitating careful clinical evaluation.
  • While hyperglycemia is common, it did not appear to negatively impact overall survival in this cohort.
Keywords:
HyperglycemicImmune checkpoint inhibitorsOverall survivalReal-world cohort

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