Current cancer therapies and their influence on glucose control

Table 1 Summary of reported characteristics of hyperglycemia incidence, onset and severity with the use of current chemotherapy agents

Characteristics by drug class	Glucocorticoids	5-FU and analogs	PI3K/mTor inhibitors	Immune checkpoint inhibitors
Incidence of new or worsening hyperglycemia	Significant, 34%-94%	Common, 11.6% DM, 11.3% IFG	Significant, 12%-50%	Rare, 0.2%-4.9%
Onset of hyperglycemia after first use	Acutely	Majority by 3 mo; 3/4 early (3rd cycle); 1/4 up to 1 yr later	Majority after first use	Majority by 4 mo, can be after first use, can be up to 1 yr later
Severity of hyperglycemic events	Usually mild, Severe possible, Multiple reports of DKA and some HHS	Mild, Case reports of DKA	Mild, No DKA	Moderate to severe, 77.8% DKA

5-FU: 5-fluorouracil; CTLA-4: Cytotoxic T-lymphocyte-associated protein 4; PI3K: Phosphatidyl inositol-3-kinase; mTOR: Mammalian target of rapamycin; DKA: Diabetic ketoacidosis; HHS: Hyperglycemic hyperosmolar syndrome; IFG: Impaired fasting glucose.