Recurrent Hypoglycemia Due to a High Titer of Insulin Antibody in Response to Exogenous Insulin Administration in Two Cases of Type 1 Diabetes

Intern Med. 2022 Mar 1;61(5):687-695. doi: 10.2169/internalmedicine.7647-21. Epub 2021 Aug 31.

Abstract

In the first case, a 60-year-old man who was using continuous subcutaneous insulin infusion (CSII), developed recurrent hypoglycemia due to insulin antibodies. This is the first report of such a case using CSII. In the second case, a 70-year-old man was follow-up case who developed hypoglycemia while using human insulin. In both cases, the hypoglycemia subsided after switching to multiple daily insulin injection and/or insulin preparation. The results of Scatchard analyses of the two cases were similar to those of cases of insulin autoimmune syndrome (IAS) that improved after recovery from hypoglycemia.The clinical characteristics and Scatchard analysis data were essentially the same as those for IAS, except for the presence of insulin administration.

Keywords: Scatchard analysis; continuous subcutaneous insulin infusion (CSII); hypoglycemia; insulin administration; insulin antibody (IAb); insulin autoimmune syndrome (IAS).

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Diabetes Mellitus, Type 1* / complications
  • Diabetes Mellitus, Type 1* / drug therapy
  • Glycated Hemoglobin / analysis
  • Humans
  • Hypoglycemia* / chemically induced
  • Hypoglycemia* / drug therapy
  • Hypoglycemic Agents / therapeutic use
  • Insulin / adverse effects
  • Insulin Antibodies
  • Insulin Infusion Systems
  • Male
  • Middle Aged

Substances

  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin
  • Insulin Antibodies