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Introduction: Multiple case studies have reported diabetic ketoacidosis (DKA) in recently-diagnosed cancer patients, especially those taking immune checkpoint inhibitors. The prevalence of DKA and other acute diabetes complications (ADC), including hypoglycemia and hyperosmolarity, and their relationship with the onset of systemic cancer therapy is unclear. Methods: This study utilized data from n=9,588 cancer patients from the Huntsman Cancer Institute, UT. Data on clinicodemographic characteristics, biomarkers, and cancer diagnoses were extracted from electronic medical records (EMR) and tumor registry. Patients included in this analysis received an ICD diagnosis of hypoglycemia, hyperosmolarity with or without coma, and/or DKA with or without coma. Systemic therapy was defined as any chemotherapy, immunotherapy or hormone therapy resulting from a specific first primary cancer diagnosis. Results: There were 243 instances of ADC within this cohort, occurring in 211 (2.2%) unique patients. Of these 211 unique patients with an ADC, 106 (50.0%) experienced their first ADC within one year after cancer diagnosis, with a median time to ADC diagnosis of 88 days. Forty-seven (44%) of these patients experienced the ADC following the onset of systemic therapy, with a median time from systemic therapy onset to ADC diagnosis of 120 days. In these 47 patients who received an ADC diagnosis following the onset of systemic therapy, 40 (85.1%) received chemotherapy (n=20 as monotherapy), 20 (42.6%) received immunotherapy (n=4 as monotherapy) and 12 (25.5%) received hormone therapy (n=2 as monotherapy). Only 54% of patients experiencing an ADC after cancer diagnosis had a history of diabetes prior to cancer, and on average their first diabetes diagnosis was 5.4 ± 4.4 years prior to their cancer diagnosis. Discussion: ADCs may be common following a cancer diagnosis, however a substantial number occurred prior to the onset of systemic cancer therapy and in patients with no prior history of diabetes. Disclosure R. Viskochil: None. S. Hardikar: None. S. Pauleck: None. M. Winn: None. K. Funai: None. M. L. Litchman: Research Support; Self; Abbott Diabetes. W. Akerley: None. H. Colman: Advisory Panel; Self; Adastra Pharmaceuticals, Orbus Therapeutics, Consultant; Self; Best Doctors/Teladoc. C. M. Ulrich: None. M. C. Playdon: None. Funding University of Utah Health/Larry H. Miller Family Wellness Initiative

Introduction: Cancer patients are more likely to develop hyperglycemia (HG) compared to cancer-free adults, and this increased risk is highest in the year following cancer diagnosis. The persistence of post-diagnosis HG and degree of glycemic control in this population is unclear. Methods: This study utilized data from n=9,588 cancer patients from the Huntsman Cancer Institute, UT. Clinicodemographic characteristics, biomarkers, and cancer diagnoses were extracted from electronic medical records (EMR) and tumor registry. Patients with a new HG diagnosis (ICD) of any kind between 30 days and 1 year after cancer diagnosis were included. Persistence of HG was determined through elevated Hemoglobin A1c (HbA1c) and/or new anti-HG medication prescription. Patients who did not survive >1 year after cancer diagnosis or were diagnosed with cancer Results: Of the 2,964 (30.9%) cancer patients with a HG diagnosis after cancer, 26.2% (n=777) were diagnosed with HG between 30 days and 1 year after cancer diagnosis, of these n=357 met criteria for HG evaluation. Data on HbA1c and/or anti-HG medication >1 but Discussion: Taken together, 82.5% of patients diagnosed with HG in the year following a cancer diagnosis still presented with HG between one and two years post-cancer diagnosis, and there was no difference by BMI among those that did and did not receive anti-HG medications. This suggests that HG post-cancer diagnosis is not a transient effect of cancer therapy (e.g., corticosteroids), and may have long-term health implications in cancer survivors. Disclosure R. Viskochil: None. S. Hardikar: None. S. Pauleck: None. M. Winn: None. K. Funai: None. M. L. Litchman: Research Support; Self; Abbott Diabetes. W. Akerley: None. H. Colman: Advisory Panel; Self; Adastra Pharmaceuticals, Orbus Therapeutics, Consultant; Self; Best Doctors/Teladoc. C. M. Ulrich: None. M. C. Playdon: None. Funding University of Utah Health/Larry H. Miller Family Wellness Initiative