[Hyperglycemic hyperosmolar non-ketotic diabetic coma with prolonged insulin-resistnace and extremely high values of insulin-IgG-binding].
The paper reports the occurrence - over a period of some days - of a hyperosmolar non ketotic coma, with prolonged relative insulin-resistnace in a micro- and macroangiopathic long term diabetic subject, after infection and minor surgery. The patient was on oral hypoglycemic treatment during the past 11 years; previously he had been treated with Protamin Zinc Insulin. The case is characterized by extremely high values of Insulin-IgG-binding (12 MU/ml), which still further increased to 20 mU/ml when an emergency insulin management was recommenced, perhaps as the result of an immunogenic booster effect. A diagram of underlying and precipitating conditions likely to lead to diabetic non-ketotic coma is presented. Exogenous anti-insulin immunitary factors are postulated as exceptional condidates for inclusion.
D000368:Aged; D001666:Binding Sites, Antibody; D003920:Diabetes Mellitus / Q000188:drug therapy; D003926:Diabetic Coma / Q000276:immunology*; D006801:Humans; D006943:Hyperglycemia / Q000276:immunology; D007074:Immunoglobulin G; D007328:Insulin / Q000276:immunology*; D007330:Insulin Antibodies; D007333:Insulin Resistance; D049528:Insulin, Long-Acting / Q000627:therapeutic use; D008297:Male; D009994:Osmolar Concentration; D013997:Time Factors
D007074:Immunoglobulin G; D007328:Insulin; D007330:Insulin Antibodies; D049528:Insulin, Long-Acting
Coma diabetico iperglicemico iperosmolare non-chetosico con relativa insulinoresistenza protratta e valori estremamente elevati di insulin-IgG-binding