title: Insulin lispro reduces insulin antibodies in a patient with type 2 diabetes with immunological insulin resistance.
abstract: We describe a 54-year-old Japanese female with type 2 diabetes admitted to our hospital with poor metabolic control. On admission the patient's HbA1c was 9.1% despite having taken over 60 U of human insulin per day for the previous 10 years. A high titer of antibodies to insulin was detected in the serum, and therefore, we decided to introduce insulin lispro with the aim of minimizing immunogenicity. Over the next 2 months, the dosage of insulin required to achieve reasonable blood glucose control was reduced, with the HbA1c level decreasing significantly to 6.8%. The patient was subsequently withdrawn from insulin and discharged on diet therapy only. This case demonstrates that insulin lispro may ameliorate resistance to insulin therapy even in the presence of human insulin antibodies.
authors.affiliation: The Second Department of Internal Medicine, Asahikawa Medical College, 078-8510 Hokkaido, Japan. mahito@asahikawa-med.ac.jp
authors.forename: Mahito
authors.initials: M
authors.lastname: Asai
authors.forename: Tutomu
authors.initials: T
authors.lastname: Kodera
authors.forename: Kanaki
authors.initials: K
authors.lastname: Ishizeki
authors.forename: Seiji
authors.initials: S
authors.lastname: Uebori
authors.forename: Tagui
authors.initials: T
authors.lastname: Kashiwaya
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Itoh
authors.forename: Isao
authors.initials: I
authors.lastname: Makino
mesh_terms: D001323:Autoantibodies / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000276:immunology*; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000276:immunology / Q000494:pharmacology* / Q000627:therapeutic use; D007328:Insulin / Q000031:analogs & derivatives* / Q000276:immunology* / Q000494:pharmacology* / Q000627:therapeutic use; D061268:Insulin Lispro; D007333:Insulin Resistance / Q000276:immunology*; D008875:Middle Aged
chemical_list: D001323:Autoantibodies; D007004:Hypoglycemic Agents; D007328:Insulin; D061268:Insulin Lispro; D005947:Glucose