Immune checkpoint inhibitors used in cancer treatment increase the risk of islet function impairment by 30%, with a 2.2-fold higher risk of severe complications and a 3.4-fold increased risk of type 1 diabetes compared to non-immunotherapy treatments.
- Cancer immunotherapy drugs increase diabetes and blood sugar problems by 30% compared to other treatments
- Risk of severe complications is 2.2 times higher, and type 1 diabetes risk is 3.4 times higher
- PD-1 inhibitors and lung cancer patients face the highest risk
How this compares to prior research
Immune checkpoint inhibitors have revolutionized cancer treatment but are known to cause immune-related side effects affecting various organs. While individual case reports and small studies documented diabetes and blood sugar problems with these drugs, the overall magnitude of risk across different drug types and cancer populations remained unclear. This meta-analysis synthesizes data from 31 randomized trials to quantify these risks systematically for the first time.
Diabetes prevalence trends, global population, 1980–1989
Key findings
- Analysis of 31 randomized trials with 15,417 cancer patients found immune checkpoint inhibitors increased islet function impairment risk by 30% compared to non-immunotherapy regimens
- Severe grade 3-5 complications occurred 2.2 times more often and type 1 diabetes developed 3.4 times more frequently in patients receiving immune checkpoint inhibitors
- PD-1 inhibitors and pembrolizumab showed the highest risk, with pembrolizumab increasing impairment incidence by 2.4-fold, while lung cancer patients faced significantly elevated risk
What this means in practice
- Ask your oncologist about blood sugar monitoring before starting immune checkpoint inhibitor therapy for cancer
- Monitor for symptoms of high blood sugar or diabetes if receiving PD-1 inhibitors or pembrolizumab
- If you have lung cancer requiring immunotherapy, discuss proactive glucose management with your care team
Frequently asked questions
What are immune checkpoint inhibitors?
Immune checkpoint inhibitors are cancer drugs that help the immune system attack tumors. Common types include PD-1 inhibitors and pembrolizumab, used to treat various cancers including lung cancer.
Can cancer immunotherapy cause diabetes?
Yes, this analysis of 31 studies found immunotherapy increases diabetes risk, particularly type 1 diabetes which occurred 3.4 times more often than with other cancer treatments.
Which cancer patients are at highest risk for blood sugar problems?
Patients with lung cancer and those receiving PD-1 inhibitors or pembrolizumab face the highest risk of developing diabetes and blood sugar complications during immunotherapy treatment.
Key terms explained
Islet function impairment
Damage to insulin-producing cells in the pancreas, leading to high blood sugar, diabetes, or diabetic ketoacidosis
PD-1 inhibitor
A type of immunotherapy drug that blocks the PD-1 protein, helping immune cells attack cancer cells more effectively
Diabetic ketoacidosis
A life-threatening complication where the body produces dangerous acids called ketones due to severe insulin deficiency
Source: Islet function impairment outcomes of immune checkpoint inhibitors in cancer patients: a systematic review and meta-analysis. · DOI: doi: 10.3389/fimmu.2026.1669492