Abstract
A 62-year female patient with an immune-origin insulin resistant diabetes was treated with sulphated and monocomponent insulin. The change in the insulin binding capacity, the neutralizing capacity and the immunoglobulin class distribution of the insulin antibody were studied. The case had been diagnosed as diabetes mellitus about two years before her admission. During the first year, and half of the next, she responded well to the usual dosage of insulin. However, in the following several months her response decreased and the insulin dosage was increased. A daily dose of 380 units of beef regular insulin was needed to control the diabetes. Sulphated insulin (13 to 20 units per day) was injected 5 months after her admission and continued over 16 months. Thereafter 14 to 16 units per day of moncomponent insulin was used. A radiopaper-chromatographic study revealed the existence of an insulin antibody in her serum. The immunoglobulin of the antibody was distributed in the IgG, IgA, and IgM classes. The light chain was the K-and L-type. Both the insulin binding and the neutralizing capacity of the antibody were stronger with beef insulin than with porcine. An insulin sensitivity test was performed before the treatment with sulphated insulin was begun. She was not sensitive to beef insulin but was sensitive to sulphated and also to bonito insulin.
One year after the beginning of sulphated insulin administration, her blood glucose responded slightly to beef insulin. About 16 months after sulphated insulin (13-20 units/day) treatment was begun, the insulin binding capacity (Bound/Total%) of 30-37% decreased to 12% which was higher than the binding capacity of the serum of insulin sensitive diabetic patients. Her diabetic condition was controlled well with the same dose of monocompoent insulin. The insulin binding capacity was 12% about 6 months after the MC-insulin treatment.
