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Insulin autoantibody (IAA) mediated insulin resistance (AMIR) is very rare in human insulin era.Here we report a typical case of a 90-year-old Chinese man who suffered from heart and renal dysfunction,lung infection and very poor blood glucose control,and meanwhile injected with higher than 200 U human insulin for his diabetes.His IAA was posi-tive with high affinity to insulin,as insulin antigen-antibody binding rate was 52% in vitro.Serum insulin level and the binding rate decreased dramatically with cession of insulin injection; also blood glucose profile restored to response to pre-vious dose insulin injection and remained during follow-up.Both the reason for the IAA formation and the solution to the AMIR were discussed in detail.
Insulin autoantibody (IAA) mediated insulin resistance (AMIR) is very rare in human insulin era. Here we report a typical case of a 90-year-old Chinese man who suffered from heart and renal dysfunction, lung infection and very poor blood glucose control , and meanwhile injected with higher than 200 U human insulin for his diabetes. His IAA was posi-tive with high affinity to insulin, as insulin antigen-antibody binding rate was 52% in vitro. Serum insulin level and the binding rate decreased dramatically with cession of insulin injection; also blood glucose profile restored to response to pre-vious dose insulin injection and remained during follow-up. Both the reason for the IAA formation and the solution to the AMIR were discussed in detail.