A novel treatment of hyperinsulinemic hypoglycemia induced by insulin antibodies with alkali administration: a case report View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2019-12

AUTHORS

Seiji Kobayashi, Houichi Amano, Yoshindo Kawaguchi, Takashi Yokoo

ABSTRACT

BACKGROUND: Insulin autoimmune syndrome is a rare cause of hyperinsulinemic hypoglycemia characterized by autoantibodies to human insulin without previous insulin use. We report a case of a patient with hyperinsulinemic hypoglycemia possibly caused by insulin antibodies induced by insulin analogs and a novel therapeutic measure for this condition. CASE PRESENTATION: An 84-year-old Japanese man with a 28-year history of type 2 diabetes and chronic kidney disease, treated with biphasic insulin aspart 30, experienced persistent early morning hypoglycemia with daytime hyperglycemia. Despite discontinuation of biphasic insulin aspart 30, the condition persisted even after the patient ate small, frequent meals. Sodium bicarbonate was administered to correct the chronic metabolic acidosis, which then rectified the early morning glucose level. CONCLUSIONS: We believe this to be the first published case of a therapeutic approach to the treatment of hyperinsulinemic hypoglycemia associated with insulin antibodies that factors in blood pH and the correction of acidosis using sodium bicarbonate, which physicians could consider. More... »

PAGES

79

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s13256-019-1989-8

DOI

http://dx.doi.org/10.1186/s13256-019-1989-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1112674644

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30853027


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