ABSTRACT
Objective:A retrospective study was conducted to analysis the clinical characteristics of 7insulin autoimmune syndrome (IAS) patients.Methods:Clinical data were collected by searching the computerized database.Results:The male-female ratio of these seven patients was 4:3; age of the four patients was between 60-70 years old;two patients with the history of Hashimoto's disease. Of the seven cases, six wereexogenous IAS. The level of insulin was excessively high, the level of C-peptide was not low, and insulin auto-antibodies (IAA) were positive of all the seven patients. The lowest blood glucose of one patient was 4.2 mmol/L. The insulin to C-peptide molar ratios were >1 in five patients. Symptoms were relieved after discontinuing use of the suspicious drugs, small frequent meals, taking acarbose and metformin.Conclusions:IAS should not be easily excluded in patients without hypoglycemia record. For diabetes patients receiving insulin therapy, exogenous IAS might be mistaken as hypoglycemia induced by insulin overdose. The identification of the genotype might be meaningful in the diagnosing and prevention of IAS.
ABSTRACT
Autoimmune hypoglycemia is characterized by hyperinsulinemia, fasting hypoglycemia, and the presence of insulin auto- antibodies without previous exposure to exogenous insulin. We experienced a case of autoimmune hypoglycemia without diabetes mellitus or any evidence of insulinoma. The insulin auto-antibody and insulin receptor auto-antibody were present. We diagnosed the patient as having autoimmune hypoglycemia and treated with glucocorticoid. After treatment, the hypoglycemic symptoms were resolved. However, four months later, the patient was readmitted with transient diabetic ketoacidosis. After recovery, he showed no signs of diabetes mellitus. We believe that insulin auto-antibodies may play a role in autoimmune hypoglycemia and diabetic ketoacidosis, but its role and mechanism are not precisely known. Further studies are needed to define the action mechanisms and the functions of insulin auto-antibodies: here we present case with a relevant literature.
Subject(s)
Humans , Male , Middle Aged , Diabetic Ketoacidosis/complications , Hypoglycemia/complications , Insulin Antibodies/blood , Magnetic Resonance ImagingABSTRACT
Objective To study the predictive value of islet cell antibody (ICA),64KD protein antibody(64KDAb) and insulin auto-antibody (IAA) in the first-degree relatives of type 1 diabetics.Methods The determination of islet autoantibody distribution in type 1 diabetes patients,first-degree relatives without diabetes and normal individuals was made.Results The results revealed that ICA and 64KDAb positive rate in type I diabetes patients and their first-degree relatives was significantly higher than normal individuals.The positive rate of 64KDAb is higher than that of ICA and IAA. Conclusion These results suggest that 64KDAb's sensitivity is higher than ICA and IAA's,so 64KDAb is more valuable as the marker of predicting type 1 diabetes.The combined determination of ICA,64KDAb and IAA might improve the value for predicting diabetes.
ABSTRACT
Objective To study the predictive value of islet cell antibody (ICA),64KD protein antibody(64KDAb) and insulin auto-antibody (IAA) in the first-degree relatives of type 1 diabetics. Methods The determination of islet autoantibody distribution in type 1 diabetes patients,first-degree relatives without diabetes and normal individuals was made. Results The results revealed that ICA and 64KDAb positive rate in type I diabetes patients and their first-degree relatives was significantly higher than normal individuals. The positive rate of 64KDAb is higher than that of ICA and IAA. Conclusion These results suggest that 64KDAb's sensitivity is higher than ICA and IAA's,so 64KDAb is more valuable as the marker of predicting type 1 diabetes. The combined determination of ICA, 64KDAb and IAA might improve the value for predicting diabetes.