title: Liraglutide improved glycaemic instability in a patient with diabetes with insulin antibodies.
abstract: Insulin antibodies sometimes cause glucose instability. A 52-year-old male patient was admitted to our department for the treatment of diabetes mellitus. From October 2003, he received insulin treatment for autoimmune pancreatitis and diabetes mellitus, but his hemoglobin A1c (HbA1c) levels gradually reached 8.0% (64 mmol/mol IFCC). In January 2010, insulin glargine and insulin aspart were introduced. In April 2010, the insulin antibody titre rose to >13.6 U/mL. In July 2010, treatment was changed to insulin glargine, metformin and miglitol. In November 2011, a further change to insulin glargine, metformin and sitagliptin was made. The insulin antibody titres gradually decreased, but HbA1c levels remained high. In November 2014, liraglutide and insulin glargine were introduced and the HbA1c levels decreased dramatically to ∼7.5% (58 mmol/mol IFCC) despite increasing insulin antibody titres (from 32.6 to >50.0 U/mL). Liraglutide successfully improved glycaemic instability due to insulin antibodies without modulating plasma insulin levels.
authors.affiliation: Department of Diabetes and Endocrinology, Graduate School of Medicine, Gifu University, Gifu, Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Kato
authors.affiliation: Department of Diabetes and Endocrinology, Graduate School of Medicine, Gifu University, Gifu, Japan.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Iizuka
authors.affiliation: Department of Diabetes and Endocrinology, Graduate School of Medicine, Gifu University, Gifu, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Niwa
authors.affiliation: Department of Diabetes and Endocrinology, Graduate School of Medicine, Gifu University, Gifu, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Takeda
mesh_terms: D001786:Blood Glucose / Q000187:drug effects; D003920:Diabetes Mellitus / Q000097:blood* / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000097:blood / Q000627:therapeutic use; D007328:Insulin / Q000097:blood*; D007330:Insulin Antibodies / Q000097:blood* / Q000187:drug effects; D000069450:Liraglutide / Q000097:blood* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D007330:Insulin Antibodies; D000069450:Liraglutide