case_images: PMC11827420_01
case_images: Image of disease progression.
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case_images: September 20, October 24, December 23, January 15, February 5 and 26, March 15, and April 9 of 2024. Each dose of Envafolimab was 400 mg, administered via subcutaneous injection. A follow-up CT on November 27, 2023, indicated a newly developed abnormal enhancing nodule at the liver apex compared to the scan on September 20 ( Figure 1 ). Subsequently, on December 22, 2023, he underwent transarterial chemoembolization (TACE), receiving treatment with "Oxaliplatin 50 mg, Levoleucovorin 100 mg, and Fluorouracil 250 mg." By February 26, 2024, the patient's fasting blood glucose and glycated albumin levels remained within normal reference ranges ( Figure 2 ).
case_images: Fasting Plasma Glucose monitoring results of the patient at different time points.
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case_images: September 20, October 24, December 23, January 15, February 5 and 26, March 15, and April 9 of 2024. Each dose of Envafolimab was 400 mg, administered via subcutaneous injection. A follow-up CT on November 27, 2023, indicated a newly developed abnormal enhancing nodule at the liver apex compared to the scan on September 20 ( Figure 1 ). Subsequently, on December 22, 2023, he underwent transarterial chemoembolization (TACE), receiving treatment with "Oxaliplatin 50 mg, Levoleucovorin 100 mg, and Fluorouracil 250 mg." By February 26, 2024, the patient's fasting blood glucose and glycated albumin levels remained within normal reference ranges ( Figure 2 ). Admission laboratory tests revealed random fingertip blood glucose levels of 29.3 mmol/L and random venous blood glucose levels of 30.73 mmol/L ( Figure 2 ), along with a glycated albumin at 28.25% and HbA1c of 8.74%. At a two-month follow-up in the outpatient setting, fasting blood glucose levels were recorded at 11.49 mmol/L ( Figure 2 ), with postprandial 2-hour glucose fluctuations between 8.5 and 20.3 mmol/L and glycated albumin at 29.81%.
case_images: Timeline of disease progression. T1DM, Type 1 Diabetes Mellitus; DKA, Diabetic Ketoacidosis.
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case_images: Main diagnostic and endocrine-related indicators during hospitalization are summarized in  Table 1 .  Figure 3  illustrates the timeline of Envafolimab treatment and the onset of T1DM with DKA.