Abstract
Drug-induced liver injury due to human insulin has rarely been reported. A 58-year-old male was diagnosed as having type 2 diabetes mellitus by another hospital in 1988, and Penfil® N administration was initiated. Although he was referred to our department in May 2001, he discontinued consulting the hospital in May 2002. He was admitted to our department because of a markedly elevated plasma glucose level of 296 mg/dl and HbA1c of 15.4% when he consulted the ophthalmological department due to a cataract in July 2004. Intensive insulin therapy with Novolin® R and N improved the plasma glucose level. However, some markers of liver injury were aggravated after 3 weeks (AST 409 IU/l, ALT 498 IU/l, and ALP 458 IU/l). The patient was suspected to have drug-induced liver injury due to human insulin based on the diagnostic criteria proposed at the DDW-J2004 Workshop. After Novolin® R and N were changed to Humalog® and Lantus®, AST, ALT, and ALP levels returned to the normal ranges. This case is interesting, because liver function recovered after human insulin was replaced with insulin analogue preparations.
