Dilemma in diagnosis of diabetes in a patient with chronic lymphocytic leukemia treated with cyclophosphamide − a paradoxical effect of immunosuppressive agent: a case report

A case report of a 56-year-old female patient who was managed for chronic lymphocytic leukemia with intravenous cyclophosphamide regimen who suddenly developed hyperglycemic state with no previous/family history of diabetes or steroid is presented. Laboratory investigation showed glycated hemoglobin of 6.1% and normal electrolyte and liver function. Diagnosis of prediabetic state was made, and the patient was commenced with oral hypoglycemic agent (metformin). Since then, blood glucose has been normalized.