OBJECTIVE: To evaluate the efficacy of the insulin analog lispro (Lys B28, Pro B29) in severe insulin resistance caused by human insulin antibodies. CASE: A 27-year-old man with a history of diabetes treated with human insulin for 3 years developed severe immunological insulin resistance caused by human insulin antibodies. Throughout follow-up (12 months) the insulin analog lispro was administered with an infusion pump as the only insulin therapy. The insulin dose decreased from an average of 300 U/day to 58 U/day, HbA1c decreased from 12.6 to 7.4%, and human insulin antibodies decreased from 8,057 to 1,860 nU/ml. Hypoglycemic episodes during early morning disappeared. CONCLUSIONS: The insulin analog lispro might be suitable for the treatment of diabetic patients with substantially increased insulin antibody levels Apparently, the structural difference between the lispro and human insulin molecules prevented lispro from binding to the human insulin antibodies in this patient and consequently was nonimmunogenic.
OBJECTIVE: To evaluate the efficacy of the insulin analog lispro (Lys B28, Pro B29) in severe insulin resistance caused by humaninsulin antibodies. CASE: A 27-year-old man with a history of diabetes treated with humaninsulin for 3 years developed severe immunological insulin resistance caused by humaninsulin antibodies. Throughout follow-up (12 months) the insulin analog lispro was administered with an infusion pump as the only insulin therapy. The insulin dose decreased from an average of 300 U/day to 58 U/day, HbA1c decreased from 12.6 to 7.4%, and humaninsulin antibodies decreased from 8,057 to 1,860 nU/ml. Hypoglycemic episodes during early morning disappeared. CONCLUSIONS: The insulin analog lispro might be suitable for the treatment of diabeticpatients with substantially increased insulin antibody levels Apparently, the structural difference between the lispro and humaninsulin molecules prevented lispro from binding to the humaninsulin antibodies in this patient and consequently was nonimmunogenic.
Authors: Victor Matheu; Eva Perez; Marta Hernández; Elisa Díaz; Ricardo Darias; Abel González; Jose C García; Inmaculada Sánchez; Laura Feliciano; Agueda Caballero; Fernando de la Torre Journal: Clin Mol Allergy Date: 2005-12-23
Authors: Giselle F Taboada; Marta S de Freitas; Fernanda H da S Corrêa; Carlos Rma Junior; Marília de B Gomes Journal: Diabetol Metab Syndr Date: 2009-11-26 Impact factor: 3.320