Document Detail


Frequent reoccurrence of hypoglycemia in a type 2 diabetic patient with insulin antibodies.
MedLine Citation:
PMID:  20799766     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Insulin antibody (IAb) may be produced in patients receiving long-term, animal-derived insulin, leading to insulin resistance or hypoglycemia. There have been very few reports of hypoglycemia caused by IAb in patients taking recombinant human insulin.
CASE REPORT: We report the case of an 82-year-old male patient with type 2 diabetes mellitus who suffered repeated episodes of severe hypoglycemia-related symptoms (including coma) prior to admission. The patient had been taking Novolin 30R, a premixed human insulin. The patient's IAb level was markedly elevated, and hypoglycemia caused by recombinant human insulin treatment-induced IAb production was diagnosed. Acarbose and metformin were prescribed, and the patient recovered uneventfully. The patient ceased taking these medications, and he was subsequently treated with recombinant human insulin to combat hyperglycemia. This was followed by reoccurrence of hypoglycemic coma. The patient was advised to avoid taking recombinant human insulin for the rest of his life and to control hyperglycemia with acarbose and metformin.
CONCLUSIONS: Although rare, hypoglycemia caused by recombinant human insulin-induced IAb production should be considered in patients with type 2 diabetes who experience repeated episodes of hypoglycemia.
Authors:
Tie-Yun Zhao; Fang Li; Zhong-Yun Xiong
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Molecular diagnosis & therapy     Volume:  14     ISSN:  1177-1062     ISO Abbreviation:  Mol Diagn Ther     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-30     Completed Date:  2010-12-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101264260     Medline TA:  Mol Diagn Ther     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  237-41     Citation Subset:  IM    
Affiliation:
Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, China. hjh560205@263.net
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MeSH Terms
Descriptor/Qualifier:
Acarbose / therapeutic use
Aged, 80 and over
Blood Glucose / drug effects
Diabetes Mellitus, Type 2 / blood,  drug therapy*,  immunology*
Glucose / therapeutic use
Humans
Hypoglycemia / diagnosis*,  drug therapy,  immunology*
Hypoglycemic Agents / adverse effects*,  therapeutic use
Insulin / adverse effects*,  blood,  immunology,  therapeutic use
Insulin Antibodies / blood*
Insulin Coma / drug therapy,  immunology
Male
Metformin / therapeutic use
Recombinant Proteins / adverse effects,  immunology
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hypoglycemic Agents; 0/Insulin Antibodies; 0/Recombinant Proteins; 11061-68-0/Insulin; 50-99-7/Glucose; 56180-94-0/Acarbose; 657-24-9/Metformin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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