2019 Volume 62 Issue 3 Pages 170-177
We herein report a 77-year-old female diabetes mellitus patient with insulin antibodies. The patient was diagnosed with diabetes mellitus at 62 years of age and had been receiving oral glucose-lowering drugs following short-term insulin therapy. At 74 years of age, her HbA1c level was 9.1 %, and insulin therapy with insulin glargine was introduced, although she had high titers of insulin antibody (binding rate: over 90 %). At 75 years of age, due to fasting hypoglycemia, her insulin began to be reduced, and insulin therapy was stopped completely 2 years later. Three months after the cessation of this therapy, she continued to show fasting hypoglycemia, possibly due to her insulin antibodies (binding rate at this point: 84 %). We administered steroid therapy along with double-filtration plasmapheresis, and her fasting hypoglycemia episodes disappeared. A series of Scatchard analyses showed a decrease in the antibody affinity and an increase in the insulin binding capacity, indicating that an insulin analogue may change the characteristics of insulin antibodies.
