Abstract
Studies have shown some tyrosine kinase inhibitors (TKIs) can influence glucose metabolism leading to either hypoglycemia or hyperglycemia which is reversable in most patients after treatment cessation. Anlotinib is a novel oral multi-target tyrosine kinase inhibitor (TKI) which has been approved for non-small cell lung cancer in China. Previous studies of anlotinib did not report it has any side effect on blood glucose, and there has been no case reporting type 1 diabetes associated with any TKI. The present case study, to our knowledge, was the first to report on an 81-year-old man with lung cancer who developed type 1 diabetes following 14 cycles treatment with TKI. The fasting plasma blood glucose and hemoglobinA1c (HbA1c) was 24.3mmol/L and 9.0%, respectively, and GADA (glutamic acid decarboxylase antibody) was more than 2000IU/ml (normal range is less than 10IU/ml) when he was diagnosed. We also conducted a literature review to explore the potential mechanism of anlotinib in inducing type 1 diabetes and recommend that self-monitoring blood glucose (SMBG) for fasting and random postprandial blood glucose at least once a week is needed for early identification of glucose dysregulation when using TKI drugs, and monthly fasting and random postprandial plasma glucose monitoring and HbA1c test every 3 months is also recommended if the SMBG protocol cannot be completed.