Immune checkpoint inhibitor–induced type 1 diabetes mellitus: incidence, risk factors, and prognostic implications − a systematic review and meta-analysis
Study context
- Population
- Adult cancer patients treated with immune checkpoint inhibitors (ICIs); studies published since January 2020 reporting ICI-T1DM
- Participants
- 65,925 patients10 studies
- Comparison
- Dual vs monotherapy ICI exposure; pre-existing DM vs none
- Outcome
- Incidence of ICI-T1DM (pooled proportion)
Methodological detailsRisk of bias assessed using validated design-specific tools
- Risk of bias assessed using validated design-specific tools
Pooled result
As reported in the abstract
Pooled incidence of ICI-T1DM
Pooled incidence of ICI-T1DM
0.58%
95% CI 0.35–0.92%
Further pooled results
Diabetic ketoacidosis (DKA) at presentation of ICI-T1DM
- Approximately presented with DKA
- 37%
Risk of ICI-T1DM: dual vs monotherapy ICI
- Dual ICI therapy significantly increased the risk of ICI-T1DM vs monotherapy
Risk of ICI-T1DM: pre-existing DM
- Pre-existing DM not significantly associated with risk of ICI-T1DM
Mortality and overall survival in patients with ICI-T1DM
- Limited to two studies with discordant findings and substantial risk of immortal time bias, precluding quantitative synthesis
Original publication
Immune checkpoint inhibitor–induced type 1 diabetes mellitus: incidence, risk factors, and prognostic implications − a systematic review and meta-analysis. Diabetes Res Clin Pract. Published 15 July 2026. doi:10.
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