Immunological Hypoglycemia Associated with Insulin Antibodies Induced by Exogenous Insulin in 11 Chinese Patients with Diabetes

Aims. To investigate the characteristics of immunological hypoglycemia associated with insulin antibodies (IAbs) induced by exogenous insulin in Chinese patients with diabetes. Methods. The clinical data of patients with immunological hypoglycemia due to IAbs were retrospectively analyzed by screeni...

Full description

Saved in:
Bibliographic Details
Main Authors: Heng Quan, Huiwen Tan, Qianrui Li, Jianwei Li, Sheyu Li
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Journal of Diabetes Research
Online Access:http://dx.doi.org/10.1155/2015/746271
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849683906205319168
author Heng Quan
Huiwen Tan
Qianrui Li
Jianwei Li
Sheyu Li
author_facet Heng Quan
Huiwen Tan
Qianrui Li
Jianwei Li
Sheyu Li
author_sort Heng Quan
collection DOAJ
description Aims. To investigate the characteristics of immunological hypoglycemia associated with insulin antibodies (IAbs) induced by exogenous insulin in Chinese patients with diabetes. Methods. The clinical data of patients with immunological hypoglycemia due to IAbs were retrospectively analyzed by screening patients with diabetes discharged from West China Hospital from 2007 to 2013. Results. A total of 11 patients (eight men and three women) were identified. Insulin-C-peptide separation was found in all patients via insulin and C-peptide release test. Previous insulin use was ceased after admission and was switched to oral hypoglycemic agents (OHAs) (8/11), lifestyle modification only (2/11), or regular human insulin (1/11). Hypoglycemia was ameliorated after a median of 20 days (interquartile range [IQR], 11–40), while IAbs turned negative after a median of 17 months (IQR, 4–19), and serum immunoreactive insulin (IRI) levels dropped substantially after a median of 22 months (IQR, 9–32) in these cases. Conclusions. In insulin-treated patients with unexpected and refractory hypoglycemia even after insulin therapy was gradually reduced or even withdrawn, IAbs induced by exogenous insulin should be considered, and insulin withdrawal might be promptly needed. The course of immunological hypoglycemia was benign and self-limited.
format Article
id doaj-art-cba281a70f374ab58d09f9fae612cdd4
institution DOAJ
issn 2314-6745
2314-6753
language English
publishDate 2015-01-01
publisher Wiley
record_format Article
series Journal of Diabetes Research
spelling doaj-art-cba281a70f374ab58d09f9fae612cdd42025-08-20T03:23:38ZengWileyJournal of Diabetes Research2314-67452314-67532015-01-01201510.1155/2015/746271746271Immunological Hypoglycemia Associated with Insulin Antibodies Induced by Exogenous Insulin in 11 Chinese Patients with DiabetesHeng Quan0Huiwen Tan1Qianrui Li2Jianwei Li3Sheyu Li4Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, ChinaDepartment of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, ChinaDepartment of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, ChinaDepartment of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, ChinaDepartment of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan 610041, ChinaAims. To investigate the characteristics of immunological hypoglycemia associated with insulin antibodies (IAbs) induced by exogenous insulin in Chinese patients with diabetes. Methods. The clinical data of patients with immunological hypoglycemia due to IAbs were retrospectively analyzed by screening patients with diabetes discharged from West China Hospital from 2007 to 2013. Results. A total of 11 patients (eight men and three women) were identified. Insulin-C-peptide separation was found in all patients via insulin and C-peptide release test. Previous insulin use was ceased after admission and was switched to oral hypoglycemic agents (OHAs) (8/11), lifestyle modification only (2/11), or regular human insulin (1/11). Hypoglycemia was ameliorated after a median of 20 days (interquartile range [IQR], 11–40), while IAbs turned negative after a median of 17 months (IQR, 4–19), and serum immunoreactive insulin (IRI) levels dropped substantially after a median of 22 months (IQR, 9–32) in these cases. Conclusions. In insulin-treated patients with unexpected and refractory hypoglycemia even after insulin therapy was gradually reduced or even withdrawn, IAbs induced by exogenous insulin should be considered, and insulin withdrawal might be promptly needed. The course of immunological hypoglycemia was benign and self-limited.http://dx.doi.org/10.1155/2015/746271
spellingShingle Heng Quan
Huiwen Tan
Qianrui Li
Jianwei Li
Sheyu Li
Immunological Hypoglycemia Associated with Insulin Antibodies Induced by Exogenous Insulin in 11 Chinese Patients with Diabetes
Journal of Diabetes Research
title Immunological Hypoglycemia Associated with Insulin Antibodies Induced by Exogenous Insulin in 11 Chinese Patients with Diabetes
title_full Immunological Hypoglycemia Associated with Insulin Antibodies Induced by Exogenous Insulin in 11 Chinese Patients with Diabetes
title_fullStr Immunological Hypoglycemia Associated with Insulin Antibodies Induced by Exogenous Insulin in 11 Chinese Patients with Diabetes
title_full_unstemmed Immunological Hypoglycemia Associated with Insulin Antibodies Induced by Exogenous Insulin in 11 Chinese Patients with Diabetes
title_short Immunological Hypoglycemia Associated with Insulin Antibodies Induced by Exogenous Insulin in 11 Chinese Patients with Diabetes
title_sort immunological hypoglycemia associated with insulin antibodies induced by exogenous insulin in 11 chinese patients with diabetes
url http://dx.doi.org/10.1155/2015/746271
work_keys_str_mv AT hengquan immunologicalhypoglycemiaassociatedwithinsulinantibodiesinducedbyexogenousinsulinin11chinesepatientswithdiabetes
AT huiwentan immunologicalhypoglycemiaassociatedwithinsulinantibodiesinducedbyexogenousinsulinin11chinesepatientswithdiabetes
AT qianruili immunologicalhypoglycemiaassociatedwithinsulinantibodiesinducedbyexogenousinsulinin11chinesepatientswithdiabetes
AT jianweili immunologicalhypoglycemiaassociatedwithinsulinantibodiesinducedbyexogenousinsulinin11chinesepatientswithdiabetes
AT sheyuli immunologicalhypoglycemiaassociatedwithinsulinantibodiesinducedbyexogenousinsulinin11chinesepatientswithdiabetes