Case report: pembrolizumab-induced acute type 1 diabetes mellitus and diabetic ketoacidosis in a perioperative esophageal squamous cell carcinoma patient

In summary, this case highlights the rare but potentially life-threatening risk of autoimmune diabetes following pembrolizumab therapy in ESCC patients. The unique clinical contributions of this case include identifying the onset of DM1 during the perioperative period and emphasizing the importance of early detection of DKA symptoms. Clinicians should remain vigilant for such irAEs, ensuring regular monitoring of blood glucose and thyroid function in patients undergoing ICI therapy. Further research is needed to clarify the pathogenesis of pembrolizumab-induced diabetes and develop guidelines for monitoring and managing these adverse events in ESCC patients.