Treatment of insulin resistance with monocomponent insulin

ABSTRACT

The case is presented of a 45-year-old diabetic female with insulin resistance. In spite of the administration of more than 1,000 units of lente insulin in addition to corticosteroids, the patient's blood sugar reached 1,000 mg%. The use of 200 units of monocomponent insulin initially, and 100 units later, was enough to control her blood sugar. The use of monocomponent insulin is suggested for the therapy of insulin resistance. Since diabetics have been treated with insulin their mortality has decreased remarkably. However, insulin therapy has brought with it some new aspects of morbidity which were not originally related to the disease but rather to insulin therapy itself[1]. Besides the known hypoglycemic action of the hormone, local and systematic allergic manifestations were reported from the early years of its use. Lipodystrophy was later added as another side effect. Insulin resistance was subsequently reported and immunogenic processes were implicated. It was demonstrated that antibodies were produced and specific types could be correlated with distinct and sometimes difficult clinical situations such as resistance and allergy[2]. This was especially true when the purification of beef and pork insulin was very crude. With recent advances in purification, highly purified insulin has become available to aid in the treatment of diabetics who develop these potentially dangerous complications. This paper reports on a case of insulin resistance that was treated with monocomponent insulin as an alternative to the conventional preparations