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Volume 28, Number 7—July 2022
Research Letter

Type 1 Diabetes Mellitus Associated with Nivolumab after Second SARS-CoV-2 Vaccination, Japan

Toshihiro Sato, Shinjiro Kodama, Keizo Kaneko, Junta Imai, and Hideki KatagiriComments to Author 
Author affiliation: Tohoku University Hospital, Sendai, Japan

Main Article


Laboratory test results for a patient who had type 1 diabetes mellitus associated with nivolumab after a second SARS-CoV-2 vaccination, Japan*

Laboratory test Value
Venous blood gas analysis
pH 7.36
pCO2, mm Hg 41.1
Bicarbonate, mmol/L 22.6
Anion gap, mmol/L
Creatinine, mg/dL 0.84
Glomerular filtration rate, mL/min/1.73 m2 79.0
Amylase, U/L 59.0
Lipase, U/L
Diabetes-related tests
Plasma glucose, mg/dL 665
HbA1c, % 8.0
Acetoacetate, μmol/L 1,936
3-hydroxybutyric acid, μmol/L 2,813
Fasting CPR, ng/mL 0.13
24-h CPR, μg/day† 5.74/3.82
GAD antibody, U/mL <5.0
IA-2 antibody, U/mL <0.4
ZnT8 antibody, U/mL
Glucagon load test
Fasting CPR, ng/mL 0.09
After 6 min CPR, ng/mL 0.12
Delta CPR, ng/mL
DNA typing
HLA-DRB1*11:01-DQB1*03:01:01 NA
HLA-DRB1*13:02:01-DQB1*06:04:01 NA

*CPR, C-peptide immunoreactivity; GAD, glutamic acid decarboxylase; HbA1c, glycated hemoglobin; HLA, human leukocyte antigen; IA-2, insulinoma-associated antigen 2; NA, not applicable; ZnT8, zinc transporter 8. †The 24-h CPR was measured twice for this patient because values can fluctuate greatly for patients who have diabetes.

Main Article

Page created: April 19, 2022
Page updated: June 18, 2022
Page reviewed: June 18, 2022
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