Development of Exogenous Insulin Antibody Syndrome in a Patient with Newly Diagnosed Type  1 Diabetes Successfully Treated with Oral Immunosuppressive Monotherapy

AbstractExogenous insulin antibody syndrome (EIAS), which rarely occurs in the patient with type  1 diabetes, results in antibody-induced insulin resistance, hyperglycemia, ketosis, ketoacidosis, and hypoglycemia when insulin is released from the saturated insulin antibodies. Recommended treatment regimens include glucocorticoids, immunosuppressants, and plasmapheresis. In the patient with typ e 1 diabetes, glucocorticoids may by inducing and/or worsening ketoacidosis be contraindicated. With immunosuppressants, various anecdotal treatment regimens have been reported. Currently the most commonly recommended regimen is intravenous immunosuppressive therapy in combination with oral immuno suppressants. Herein we describe a patient in whom oral immunosuppressant monotherapy with mycophenolate resulted in the cure of EIAS, thus avoiding the expense associated with intravenous immunosuppressant therapy and/or hospitalization for plasmapheresis.
Source: Diabetes Therapy - Category: Endocrinology Source Type: research