title: Use of the continuous glucose monitoring system to treat  insulin autoimmune syndrome: quantification of glucose  excursions and evaluation of treatment efficacy.
abstract: BACKGROUND
  Autoimmune hypoglycaemia, based on the presence of autoantibodies directed against endogenous insulin (insulin autoimmune syndrome or Hirata's disease), is a rare cause of hypoglycaemia. Treatment of the disease is not standardized and various therapeutic options have been proposed. We wondered whether using a continuous glucose-monitoring system could help quantify precisely glucose excursions and allow evaluation of treatment efficacy.
  
  
  METHODS
  A 44-year-old Caucasian patient with insulin autoimmune syndrome was studied for 7 days using a continuous glucose monitoring system under various treatment regimens, i.e. diet modification, high-dose corticosteroids, alpha-glucosidase inhibitors, and plasmapheresis.
  
  
  CONCLUSIONS
  Continuous glucose monitoring system data confirmed that insulin autoimmune syndrome alternated between periods of prandial hyperglycaemia and interprandial hypoglycaemia. Alpha glucosidase inhibitors and plasmapheresis were more potent in limiting glucose excursions than corticosteroid or diet-only treatments. The continuous glucose monitoring system appears to be a useful tool in the management of insulin autoimmune syndrome.
authors: M
authors: M
authors: Philippon
authors: S
authors: S
authors: Sejil
authors: M
authors: M
authors: Mugnier
authors: L
authors: L
authors: Rocher
authors: C
authors: C
authors: Guibergia
authors: B
authors: B
authors: Vialettes
authors: B
authors: B
authors: Delenne
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy; D015190:Blood Glucose Self-Monitoring; D050528:Diet, Carbohydrate-Restricted; D065089:Glycoside Hydrolase Inhibitors / Q000627:therapeutic use*; D006801:Humans; D006943:Hyperglycemia / Q000097:blood* / Q000628:therapy; D007003:Hypoglycemia / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007330:Insulin Antibodies / Q000097:blood*; D008297:Male; D010956:Plasmapheresis; D013577:Syndrome; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D065089:Glycoside Hydrolase Inhibitors; D007004:Hypoglycemic Agents; D007330:Insulin Antibodies