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

Ryoichi Kawamura; Satoshi Miyao; Hiroshi Onuma; Yasuko Uchigata; Eiji Kawasaki; Jun Ohashi; Sanshiro Shiraishi; Wataru Nishida; Maki Yokomoto-Umakoshi; Yasunori Takata; Haruhiko Osawa; Hideichi Makino

doi:10.2169/internalmedicine.7647-21

CASE REPORTS

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

Ryoichi Kawamura, Satoshi Miyao, Hiroshi Onuma, Yasuko Uchigata, Eiji Kawasaki, Jun Ohashi, Sanshiro Shiraishi, Wataru Nishida, Maki Yokomoto-Umakoshi, Yasunori Takata, Haruhiko Osawa, Hideichi Makino

Author information

Ryoichi Kawamura
Department of Diabetes and Molecular Genetics, Ehime University Graduate School of Medicine, Japan
Satoshi Miyao
Shiraishi Hospital Diabetes Center, Japan
Hiroshi Onuma
Department of Diabetes and Molecular Genetics, Ehime University Graduate School of Medicine, Japan
Department of Diabetes, Endocrine and Metabolic Disease, Tokyo Women's Medical University Yachiyo Medical Center, Japan
Yasuko Uchigata
Tokyo Women's Medical University Medical Center East, Japan
Eiji Kawasaki
Department of Diabetes and Endocrinology, Shin-Koga Hospital, Japan
Jun Ohashi
Department of Biological Sciences, Graduate School of Science, The University of Tokyo, Japan
Sanshiro Shiraishi
Shiraishi Hospital Diabetes Center, Japan
Wataru Nishida
Department of Diabetes and Molecular Genetics, Ehime University Graduate School of Medicine, Japan
Maki Yokomoto-Umakoshi
Department of Diabetes and Molecular Genetics, Ehime University Graduate School of Medicine, Japan
Yasunori Takata
Department of Diabetes and Molecular Genetics, Ehime University Graduate School of Medicine, Japan
Haruhiko Osawa
Department of Diabetes and Molecular Genetics, Ehime University Graduate School of Medicine, Japan
Hideichi Makino
Department of Diabetes and Molecular Genetics, Ehime University Graduate School of Medicine, Japan
Shiraishi Hospital Diabetes Center, Japan

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

JOURNAL OPEN ACCESS

2022 Volume 61 Issue 5 Pages 687-695

DOI https://doi.org/10.2169/internalmedicine.7647-21

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Details

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.

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