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About
MNI Leadership Board
HCP Resources
HCP Consensus Statements from
CJON
HCP Toolkits
BRAF Testing
Care Step Pathways
Facebook Q&A Community
Side Effect Search
Education
Videos
HCP Videos
Patient Videos
Patient Resources
Patient Action Plans
Options for Stage III Melanoma
BRAF Q&A
International Resources
Australia
Canada
France
Germany
Italy
Portugal
Spain
UK
Type 1 Diabetes Mellitus (immune destruction of beta cells in pancreas)
Grading Toxicity (Based on Fasting Glucose)
Grade 1 (Mild)
Grade 2 (Moderate)
Grade 3 (Severe)
Grade 4 (Potentially Life-Threatening)
Fasting glucose value >ULN – 160 mg/dL
Fasting glucose value >160 – 250 mg/dL
Fasting glucose value >250 – 500 mg/dL, hospitalization indicated
Fasting glucose value >500 mg/dL, life-threatening consequences
Management
Overall Strategy:
Immunotherapy may be withheld until blood glucose is regulated
Insulin therapy
Hydration
Endocrine consult
Nursing Implementation:
Discuss that DM1 will likely be permanent
Review signs and symptoms of hyper/hypoglycemia
Follow patients closely with checks on blood glucose levels, fruity breath, and other symptoms (e.g., increased infections)
Assure early intervention
Provide insulin education (or refer)
Discuss possibility of other immune-related AEs, including others of endocrine origin
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