Clinical Features of Type B Insulin Resistance in Japanese Patients: Case Report and Survey-Based Case Series Study
Type B insulin resistance (TBIR) is an extremely rare disease characterized by marked hyperglycemia and insulin resistance and often coexists with autoimmune diseases. The characteristics, symptoms, blood glucose patterns, comorbidities, and treatments of TBIR all vary and are not defined. In this s...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2020/4359787 |
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| author | Yusuke Hirota Hirotsugu Suwanai Toshimasa Yamauchi Takashi Kadowaki |
| author_facet | Yusuke Hirota Hirotsugu Suwanai Toshimasa Yamauchi Takashi Kadowaki |
| author_sort | Yusuke Hirota |
| collection | DOAJ |
| description | Type B insulin resistance (TBIR) is an extremely rare disease characterized by marked hyperglycemia and insulin resistance and often coexists with autoimmune diseases. The characteristics, symptoms, blood glucose patterns, comorbidities, and treatments of TBIR all vary and are not defined. In this study, we described a case of TBIR that developed 6 months after DPP-4 inhibitor administration and immediately after the patient caught a cold. Treatment using prednisolone and insulin-like growth factor-1 was effective. We also conducted an observational survey-based case series study in a Japanese cohort comprising 21 cases. The average age of onset of TBIR was 62.3±14.8 (17–84) years, and 61.9% of subjects were male. The majority of patients (90.4%) were 50 years old and over. During the study period, there was a high percentage (85.7%) of episodes of hypoglycemia, which was the trigger for diagnosis in more than 50% of cases. Glycemic patterns included 7 cases of hyperglycemia (33.3%), 10 cases of hypoglycemia (47.6%), and 4 cases of both hyperglycemia and hypoglycemia (19.1%). In the hypoglycemic group, 90.0% of patients were male. Furthermore, 71.4% of cases were antinuclear antibody positive, and 81.0% of cases were complicated with autoimmune disease. Systemic lupus erythematosus (38.1%) and Sjögren’s syndrome (23.8%) were relatively common as coexisting autoimmune diseases. Treatment was based on prednisolone use, which was used in 88.9% of patients. On the other hand, the effect of IGF-1 was limited. Overall, the prognosis of TBIR was good. |
| format | Article |
| id | doaj-art-d1b9e01082284d4ea91bbd8f91674c19 |
| institution | DOAJ |
| issn | 2314-6745 2314-6753 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-d1b9e01082284d4ea91bbd8f91674c192025-08-20T03:23:59ZengWileyJournal of Diabetes Research2314-67452314-67532020-01-01202010.1155/2020/43597874359787Clinical Features of Type B Insulin Resistance in Japanese Patients: Case Report and Survey-Based Case Series StudyYusuke Hirota0Hirotsugu Suwanai1Toshimasa Yamauchi2Takashi Kadowaki3Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, JapanDepartment of Diabetes, Metabolism and Endocrinology, Tokyo Medical University, Tokyo 160-0023, JapanDepartment of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, JapanDepartment of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, JapanType B insulin resistance (TBIR) is an extremely rare disease characterized by marked hyperglycemia and insulin resistance and often coexists with autoimmune diseases. The characteristics, symptoms, blood glucose patterns, comorbidities, and treatments of TBIR all vary and are not defined. In this study, we described a case of TBIR that developed 6 months after DPP-4 inhibitor administration and immediately after the patient caught a cold. Treatment using prednisolone and insulin-like growth factor-1 was effective. We also conducted an observational survey-based case series study in a Japanese cohort comprising 21 cases. The average age of onset of TBIR was 62.3±14.8 (17–84) years, and 61.9% of subjects were male. The majority of patients (90.4%) were 50 years old and over. During the study period, there was a high percentage (85.7%) of episodes of hypoglycemia, which was the trigger for diagnosis in more than 50% of cases. Glycemic patterns included 7 cases of hyperglycemia (33.3%), 10 cases of hypoglycemia (47.6%), and 4 cases of both hyperglycemia and hypoglycemia (19.1%). In the hypoglycemic group, 90.0% of patients were male. Furthermore, 71.4% of cases were antinuclear antibody positive, and 81.0% of cases were complicated with autoimmune disease. Systemic lupus erythematosus (38.1%) and Sjögren’s syndrome (23.8%) were relatively common as coexisting autoimmune diseases. Treatment was based on prednisolone use, which was used in 88.9% of patients. On the other hand, the effect of IGF-1 was limited. Overall, the prognosis of TBIR was good.http://dx.doi.org/10.1155/2020/4359787 |
| spellingShingle | Yusuke Hirota Hirotsugu Suwanai Toshimasa Yamauchi Takashi Kadowaki Clinical Features of Type B Insulin Resistance in Japanese Patients: Case Report and Survey-Based Case Series Study Journal of Diabetes Research |
| title | Clinical Features of Type B Insulin Resistance in Japanese Patients: Case Report and Survey-Based Case Series Study |
| title_full | Clinical Features of Type B Insulin Resistance in Japanese Patients: Case Report and Survey-Based Case Series Study |
| title_fullStr | Clinical Features of Type B Insulin Resistance in Japanese Patients: Case Report and Survey-Based Case Series Study |
| title_full_unstemmed | Clinical Features of Type B Insulin Resistance in Japanese Patients: Case Report and Survey-Based Case Series Study |
| title_short | Clinical Features of Type B Insulin Resistance in Japanese Patients: Case Report and Survey-Based Case Series Study |
| title_sort | clinical features of type b insulin resistance in japanese patients case report and survey based case series study |
| url | http://dx.doi.org/10.1155/2020/4359787 |
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