Insulin autoimmune syndrome in a health supplement user: the effectiveness of cornstarch therapy for treating hypoglycemia.
A 70-year-old woman with no history of diabetes was admitted to the hospital for the management of hypoglycemia. Her fasting plasma glucose level was 54 mg/dL with an extremely high serum immunoreactive insulin level (1210 μU/mL). She had high titers of anti-insulin antibodies and exhibited the DRB1*0406 genotype for HLA-DR4, leading to a diagnosis of insulin autoimmune syndrome. She had been taking several health preparations for approximately 10 years; however, all were thiol group-free. Due to frequent episodes of nocturnal hypoglycemia, the health preparations were discontinued and the patient was treated with cornstarch. This protocol successfully ameliorated the hypoglycemic episodes and normalized the patient's laboratory and serological test results.
Diabetes Center, Toyonaka Municipal Hospital, Japan.
Arichika
A
Deguchi
Yukiyoshi
Y
Okauchi
Setsuyo
S
Suehara
Ikuo
I
Mineo
D000368:Aged; D001323:Autoantibodies / Q000097:blood*; D001327:Autoimmune Diseases / Q000178:diet therapy* / Q000209:etiology* / Q000276:immunology; D019587:Dietary Supplements / Q000009:adverse effects / Q000032:analysis; D005260:Female; D015804:HLA-DR4 Antigen / Q000235:genetics; D059811:HLA-DRB1 Chains / Q000235:genetics; D006801:Humans; D007003:Hypoglycemia / Q000178:diet therapy* / Q000209:etiology* / Q000276:immunology; D007328:Insulin / Q000276:immunology*; D007330:Insulin Antibodies / Q000097:blood*; D008715:Methionine / Q000009:adverse effects; D013213:Starch / Q000627:therapeutic use*; D013577:Syndrome
D001323:Autoantibodies; D015804:HLA-DR4 Antigen; D059811:HLA-DRB1 Chains; C518670:HLA-DRB1*04:06 antigen; D007328:Insulin; D007330:Insulin Antibodies; D013213:Starch; D008715:Methionine