Insulin and heparin challenge tests are useful for choosing an optimal insulin regimen in a case of subcutaneous insulin resistance

AbstractA 38 ‐year‐old woman with type 1 diabetes, whose fasting plasma glucose levels were>500 mg/dL under 176 U/day of subcutaneous insulin injection, was admitted to our hospital. When insulin was administrated intravenously, she was able to maintain favorable glycemic control even under 24 U/day of regular insulin; indicating that subcutaneous insulin resistance (SIR) was accompanied. To choose an optimal insulin regimen, we performed subcutaneous insulin challenge tests without or with heparin mixture and found a cocktail of insulin lispro and heparin could reduce blood glucose levels markedly. In consequence, she achieved favorable blood glucose control by continuous subcutaneous insulin infusion of the cocktail. In summary, the insulin and heparin challenge tests are useful for choosing an optimal insulin regimen in cases of SIR.

Source: Journal of Diabetes Investigation - April 7, 2020 Category: Endocrinology Authors: Yuko Nakamura, Mototsugu Nagao, Shunsuke Kobayashi, Takeshi Oba, Yuki Shuto, Izumi Fukuda, Shinichi Oikawa, Hitoshi Sugihara Tags: CASE REPORT Source Type: research