Fasting hypoglycemia, which persisted for 3 days after insulin treatment was stopped,occurred in a patient with non-insulin-dependent diabetes mellitus who had inappropriate plasma free-insulin levels (18–25 μU/ml) and extremely high antibody-bound insulin (>20,000 μU/ml) but normal counterregulatory hormone secretion and plasma C-peptide levels. The amount of antibody-bound insulin decreased in a biphasic pattern over13 mo of observation with an initial half-life of 35 days and a more gradual decrease with a half-life of 160 days. The number of high-affinity antibody binding sites was virtually identical to the amount of antibody-bound insulin in the patient's plasma. We conclude that the patient's fasting hyperinsulinemia and hypoglycemia were due to release of antibody-bound insulin.
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March 01 1987
Prolonged Fasting Hypoglycemia Due to Insulin Antibodies in Patient With Non-Insulin-Dependent Diabetes Mellitus: Effect of Insulin Withdrawal on Insulin-Antibody—Binding Kinetics
Timon W Van Haeften, MD;
Timon W Van Haeften, MD
Diabetes Research Laboratory, Endocrine Research Unit, Departments of Medicine and Physiology, Mayo Medical School and Mayo Clinic
Rochester, Minnesota
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Bethany A Krom, BS;
Bethany A Krom, BS
Diabetes Research Laboratory, Endocrine Research Unit, Departments of Medicine and Physiology, Mayo Medical School and Mayo Clinic
Rochester, Minnesota
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John E Gerich, MD
John E Gerich, MD
Diabetes Research Laboratory, Endocrine Research Unit, Departments of Medicine and Physiology, Mayo Medical School and Mayo Clinic
Rochester, Minnesota
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Address correspondence and reprint requests to John E. Gerich, MD, University of Pittsburgh, Clinical Research Center, R-3488 Presbyterian Hospital, Pittsburgh, PA 15261.
Citation
Timon W Van Haeften, Bethany A Krom, John E Gerich; Prolonged Fasting Hypoglycemia Due to Insulin Antibodies in Patient With Non-Insulin-Dependent Diabetes Mellitus: Effect of Insulin Withdrawal on Insulin-Antibody—Binding Kinetics. Diabetes Care 1 March 1987; 10 (2): 160–163. https://doi.org/10.2337/diacare.10.2.160
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