Overcoming of insulin autoantibody mediated insulin resistance in a Chinese elderly patient with multi-organ dysfunction by withdrawal of insulin injection:a case report and review of literature

Insulin autoantibody (IAA) mediated insulin resistance (AMIR) is very rare in human insulin era.Here we report a typical case of a 90-year-old Chinese man who suffered from heart and renal dysfunction,lung infection and very poor blood glucose control,and meanwhile injected with higher than 200 U human insulin for his diabetes.His IAA was posi-tive with high affinity to insulin,as insulin antigen-antibody binding rate was 52% in vitro.Serum insulin level and the binding rate decreased dramatically with cession of insulin injection; also blood glucose profile restored to response to pre-vious dose insulin injection and remained during follow-up.Both the reason for the IAA formation and the solution to the AMIR were discussed in detail.