Journal of Diabetes Research

Research Article

Immunological Hypoglycemia Associated with Insulin Antibodies Induced by Exogenous Insulin in 11 Chinese Patients with Diabetes

Table 2

Results of 11 cases with immunological hypoglycemia associated with IAbs on admission and during follow-up.


Case	On admission							During follow-up							Alternative treatment after admission
	Fasting status			After meal tolerance test 2 h			HbA1c	Fasting status			After meal tolerance test 2 h			HbA1c
	PG mmol/L	Serum IRI^* pmol/L	Serum CPR nmol/L	PG mmol/L	Serum IRI^* pmol/L	Serum CPR nmol/L	% (mmol/mol)	PG mmol/L	Serum IRI^* pmol/L	Serum CPR nmol/L	PG mmol/L	Serum IRI^* pmol/L	Serum CPR nmol/L	% (mmol/mol)

1	6.05	>6000.00	4.930	21.00	>6000.00	6.660	5.6 (38)	5.28	1075.20	1.140	20.46	2061.00	2.700	NA	NovoNorm 0.5 mg bid
2	3.66	>6000.00	2.530	16.66	>6000.00	3.160	7.3 (56)	5.92	103.68	0.512	15.86	343.80	2.750	6.1 (43)	Lifestyle modification
3	4.97	1697.40	1.010	13.24	>6000.00	3.800	6.1 (43)	6.84	36.66	0.681	5.90	126.90	2.140	6.0 (42)	Glucobay 50 mg tid
4	5.44	4342.20	0.675	12.65	>6000.00	4.220	5.7 (39)	NA	NA	NA	NA	NA	NA	6.4 (46)	Glucobay 50 mg tid
5	5.93	>6000.00	3.380	17.86	>6000.00	7.130	5.9 (41)	6.54	110.94	0.639	13.39	441.00	2.650	5.2 (33)	Glucobay 25 mg tid
6	9.08	>6000.00	3.130	26.09	>6000.00	3.320	9.6 (81)	NA	NA	NA	NA	NA	NA	NA	Starlix 60 mg tid, Glucobay 100 mg tid, Januvia 100 mg qd
7	4.52	2437.20	1.110	17.85	>6000.00	3.100	6.3 (45)	NA	NA	NA	NA	NA	NA	NA	Glucocorticoid^†, lifestyle modification
8	8.37	4493.40	1.810	19.53	>6000.00	3.350	6.5 (48)	5.74	258.66	NA	12.96	445.44	NA	6.7 (50)	Glucobay 50 mg tid
9	3.86	>6000.00	1.050	17.38	>6000.00	1.970	6.4 (46)	7.90	1021.80	0.817	18.01	2241.60	1.950	7.1 (54)	Glucobay 75 mg tid
10	6.10	1185.60	0.580	18.80	2958.60	1.590	6.8 (51)	NA	NA	NA	NA	NA	NA	NA	Gansulin R^# 4IU tid
11	6.30	>6000.00	2.670	23.70	>6000.00	3.480	8.6 (70)	NA	NA	NA	NA	NA	NA	NA	Glucobay 50 mg tid, Glucophage 500 mg bid

PG: plasma glucose, IRI: immunoreactive insulin, CPR: C-peptide reactivity, and NA: not available.
^*Insulin concentration conversion formula was described asU/mL 6 = pmol/L (http://diabetes.diabetesjournals.org/site/misc/SIunits.pdf).
^†Methylprednisolone was infused intravenously 40 mg/d for 3 days, followed by oral prednisone 30 mg/d, which was reduced gradually and discontinued on day 16.
^#Gansulin R is biosynthetic human insulin produced by Dongbao Pharmaceutical Co., Ltd., in China.