# Risk Factors Associated with the Development of Immune-Checkpoint Inhibitor Diabetes Mellitus: An Integrative Review

## TL;DR

This review identifies risk factors for a new type of diabetes caused by cancer immunotherapy, including age, prior diabetes, genetic factors, and treatment exposure.

## Contribution

The study provides a comprehensive synthesis of risk factors for immune-checkpoint inhibitor diabetes mellitus using an epidemiological framework.

## Key findings

- Older age is associated with an increased risk of ICI-DM.
- A prior medical history of diabetes increases the likelihood of developing ICI-DM.
- Genetic susceptibility and immunotherapy exposure are linked to ICI-DM risk.

## Abstract

Immune checkpoint inhibitor diabetes mellitus (ICI-DM) is an emerging phenomenon in the adult oncology population, with an increased incidence reflecting the increased use of immunotherapy; however, risk factors for ICI-DM have not been fully identified. The aim of this integrated literature review was to synthesize the published literature on ICI-DM and the factors associated with an increased risk for its development. The review was guided by Sanieszko’s Epidemiology Triad theoretical framework. We conducted a literature search using the Cumulative Index to Nursing and Allied Health Literature, Web of Science, and PubMed databases. The analysis included 2030 studies that met the search criteria, 23 of which were peer-reviewed articles that met the inclusion criteria. The results demonstrated a positive relationship between older age, medical history of diabetes, the presence of susceptible alleles, and exposure to immunotherapy, with an increased risk for ICI-DM. Future studies should include larger samples, more diverse populations, and a broad range of institutions to confirm the risk factors associated with ICI-DM.