Extreme Insulin Resistance From Insulin Antibodies (Not Insulin Receptor Antibodies) Successfully Treated With Combination Immunosuppressive Therapy
| Autor: | Juan Carlos Jaume, Shahnawaz Imam, Jennifer B. Hao, Noha Elnagar, Maria A. Alfonso-Jaume, Pervaiz Dar |
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| Rok vydání: | 2016 |
| Předmět: |
Advanced and Specialized Nursing
medicine.medical_specialty biology Fasting Hypoglycemia business.industry Endocrinology Diabetes and Metabolism Insulin medicine.medical_treatment 030209 endocrinology & metabolism Type 2 diabetes 030204 cardiovascular system & hematology Hypoglycemia medicine.disease 03 medical and health sciences Insulin receptor 0302 clinical medicine Endocrinology Insulin resistance Postprandial Internal medicine Diabetes mellitus Internal Medicine medicine biology.protein business |
| Zdroj: | Diabetes care. 40(2) |
| ISSN: | 1935-5548 |
| Popis: | A relationship between insulin resistance (IR) and insulin antibodies (IAs) was first described in the 1950s and was thought to be due to the use of nonhuman insulins (1). Since the introduction of human insulin, the presence of IAs and consequent IR was felt to be clinically insignificant (2). The presence of high levels of IAs, associated with random hypoglycemia in insulin-naive patients, is termed insulin autoimmune syndrome or Hirata disease (3,4). In some cases, postprandial hyperglycemia (insulin bound to antibody) and fasting hypoglycemia (disassociation of bound insulin from antibodies) are both described as mechanisms of disease (5). These IAs are thought to be of low affinity and never lead to IR. We present the case of a 65-year-old man with type 2 diabetes and extreme IR who was found to have IAs. The patient was never exposed to nonhuman … |
| Databáze: | OpenAIRE |
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