Type 1 Diabetes Mellitus (immune destruction of beta cells in pancreas)

Grading Toxicity (Based on Fasting Glucose)

  • 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


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