title: The effects of liraglutide on both hypereosinophilic insulin allergy and the characteristics of anti-insulin antibodies in type 2 diabetes mellitus: a case report.
abstract: BACKGROUND
  Liraglutide is one of the glucagon-like peptide-1 analogs; there are only a few reports of liraglutide being used for the treatment of insulin allergy. Furthermore, anti-insulin immunoglobulin G antibodies are occasionally detected in patients with diabetes. Hence, we report a case in which switching to liraglutide therapy ameliorated both the symptoms of insulin allergy with hypereosinophilia and the characteristics of insulin antibodies in a patient with type 2 diabetes mellitus.
  
  
  METHODS
  We present the case of a 70-year-old Japanese man with type 2 diabetes who developed insulin allergy with hypereosinophilia. Anti-insulin antibodies, high glycated hemoglobin levels (approximately 12 %), and high serum insulin levels were detected. Because a change in his insulin treatment was inefficient, treatment with liraglutide to protect residual insulin secretion was started, resulting in improvements in his insulin allergy, serum glycated hemoglobin, insulin, and eosinophil levels. Scatchard plots revealed decreased binding capacity and increased affinity constant for high affinity sites of anti-insulin antibodies.
  
  
  CONCLUSIONS
  Liraglutide might be useful for treating insulin allergy and anti-insulin antibodies in patients with type 2 diabetes.
authors.affiliation: Department of Diabetology, Endocrinology, and Metabolism, Fukushima Medical University, Fukushima, 960-1295, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hirai
authors.affiliation: Department of Diabetology, Endocrinology, and Metabolism, Fukushima Medical University, Fukushima, 960-1295, Japan.
authors.forename: Emi
authors.initials: E
authors.lastname: Ogata
authors.affiliation: Department of Dermatology, Fukushima Medical University, Fukushima, 960-1295, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kikuchi
authors.affiliation: Department of Diabetology, Endocrinology, and Metabolism, Fukushima Medical University, Fukushima, 960-1295, Japan.
authors.forename: Teruyuki
authors.initials: T
authors.lastname: Kohno
authors.affiliation: Department of Diabetology, Endocrinology, and Metabolism, Fukushima Medical University, Fukushima, 960-1295, Japan.
authors.forename: Noritaka
authors.initials: N
authors.lastname: Machii
authors.affiliation: Department of Diabetology, Endocrinology, and Metabolism, Fukushima Medical University, Fukushima, 960-1295, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Hasegawa
authors.affiliation: Department of Diabetology, Endocrinology, and Metabolism, Fukushima Medical University, Fukushima, 960-1295, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Diabetology, Endocrinology, and Metabolism, Fukushima Medical University, Fukushima, 960-1295, Japan. hiroakis-tky@umin.ac.jp.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Satoh
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000276:immunology; D004804:Eosinophils / Q000187:drug effects / Q000276:immunology; D006801:Humans; D006967:Hypersensitivity / Q000150:complications* / Q000188:drug therapy* / Q000276:immunology; D007004:Hypoglycemic Agents / Q000276:immunology / Q000627:therapeutic use; D007328:Insulin / Q000009:adverse effects* / Q000276:immunology / Q000627:therapeutic use; D007330:Insulin Antibodies / Q000187:drug effects / Q000276:immunology*; D000069450:Liraglutide / Q000276:immunology / Q000627:therapeutic use*; D008297:Male
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D007330:Insulin Antibodies; D000069450:Liraglutide
keywords: Anti-insulin immunoglobulin G antibodies; Human insulin-specific immunoglobulin E; Hypereosinophilia; Insulin allergy; Liraglutide