cliot (version 1.0.0)

irae_endocrine_diabetes_grading: irAE Grading for Diabetes Mellitus (Endocrine Toxicities)

Description

Calculates the CTCAE severity grade for hyperglycemia/diabetes mellitus associated with immune checkpoint inhibitor (ICPi) therapy. Grading is based on fasting glucose levels and the presence of life-threatening complications like ketoacidosis.

Usage

irae_endocrine_diabetes_grading(fasting_glucose_mg_dl, metabolic_acidosis_present,
                                insulin_dependence)

Value

A list containing:

CTCAE_Grade

The calculated adverse event grade (1-4).

Definition

Clinical description of the grade.

Management

Recommended management strategy based on ASCO guidelines.

Arguments

fasting_glucose_mg_dl

Numeric. Fasting plasma glucose level in mg/dL.

metabolic_acidosis_present

Numeric (0 or 1). Presence of ketoacidosis or metabolic acidosis. (1 = Yes).

insulin_dependence

Numeric (0 or 1). Does the patient require insulin for control? (1 = Yes).

References

Brahmer JR, Lacchetti C, Schneider BJ, et al. Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol. 2018;36(17):1714-1768. doi:10.1200/JCO.2017.77.6385

Examples

# Example 1: Severe Hyperglycemia
# Glucose 400 mg/dL, No Acidosis, Needs Insulin
irae_endocrine_diabetes_grading(400, 0, 1)

# Example 2: DKA (Life-threatening)
# Glucose 600 mg/dL, Acidosis Present
irae_endocrine_diabetes_grading(600, 1, 1)