Dear EditorWe would like to share ideas on the publication “Diabetic ketoacidosis shortly after COVID‐19 vaccination in a non‐small ‐cell lung cancer patient receiving combination of PD‐1 and CTLA‐4 inhibitors: A case report.” Makiguchi et al. stated: “We speculate that the immune‐related adverse event and immunogenicity of vaccination synergistically induced DKA.
” We accept that the COVID‐19 vaccination may have side effects. Sasaki et al. presented an intriguing underlying pathomechanism in which the vaccine could cause aberrant immunity and DKA.
However, there is a lengthy time between vaccination and the onset of diabetes. We should be aware of the likelihood of a medical issue co‐occurring with the COVID‐19 vaccine that can lead to type 1 diabetes in a COVID‐19 vaccine recipient. A vaccination recipient, for example, could develop dengue,
and dengue could be a cause of DKA.
Finally, we agree with the conclusions of Sasaki et al.2 on the importance of a thorough assessment of the problem and the recognition of probable vaccination‐induced diabetes. On the other hand, we would like to add a note about another possible concurrent issue that could cause DKA in a vaccine recipient.
CONFLICT OF INTEREST
The authors confirm that there are no conflicts of interest.