Abstract
A 30-year-old woman with diabetes mellitus caused by an insulin receptor abnormality was admitted for glycemic control. She had been diagnosed as having glycosuria at the age of 10 years and was admitted to a hospital. Careful examinations showed that she had insulin resistance, acanthosis nigricans, and decreased insulin receptor binding on red blood cells, suggesting that the disorder was due to a type A insulin receptor abnormality. Treatment was started with insulin-like growth factor 1 (IGF-1) (0.07 mg/kg/day) . However, glycemic control remained poor (glycosylated hemoglobin [HbA1c], 8～10%) . She was admitted to our hospital to receive appropriate therapy for her insulin receptor abnormality. Meal tolerance tests under some established therapies for insulin receptor abnormality, such as IGF-1, insulin, metformin and pioglitazone, indicated that a combined treatment with IGF-1 (0.14 mg/kg/day) and metformin (1000 mg/day) was feasible. Her HbA1c level improved from 9.0% to 6.8% at 8 months after discharge, and good control (HbA1c < 6.5%) has been continued for 22 months. We report here the case of a woman treated with IGF-1 for 19 years who has not developed retinopathy or nephropathy.
