Diagnosis and treatment of anti-insulin antibody-mediated labile glycaemia in insulin-treated diabetes.

ABSTRACT:

Aims

Anti-insulin antibodies in insulin-treated diabetes can derange glycaemia, but are under-recognised. Detection of significant antibodies is complicated by antigenically distinct insulin analogues. We evaluated a pragmatic biochemical approach to identifying actionable antibodies, and assessed its utility in therapeutic decision making.

Methods

Forty people with insulin-treated diabetes and combinations of insulin resistance, nocturnal/matutinal hypoglycaemia, and unexplained ketoacidosis were studied using broad-specificity insulin immunoassays, polyethylene glycol (PEG) precipitation and gel filtration chromatography (GFC) with or without ex vivo insulin preincubation.

Results

Twenty-seven people had insulin immunoreactivity (IIR) below 3000 pmol/L that fell les

SUBMITTER: Church DS 

PROVIDER: S-EPMC10946589 | biostudies-literature | 2023 Nov

REPOSITORIES: biostudies-literature