A case of insulin resistant diabetes with possible antibodies to insulin receptors.

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  • WASADA TARO
    The Third Detartment of Internal Medicine, Faculty of Medicine, Kyushu University
  • SAKIMOTO TETURO
    The Third Detartment of Internal Medicine, Faculty of Medicine, Kyushu University
  • ASO YOSHINORI
    The Third Detartment of Internal Medicine, Faculty of Medicine, Kyushu University
  • KATO KEN-ICHI
    The Third Detartment of Internal Medicine, Faculty of Medicine, Kyushu University
  • IBAYASHI HIROSHI
    The Third Detartment of Internal Medicine, Faculty of Medicine, Kyushu University
  • OMORI YASUE
    The Diabetes Center, The Tokyo Women's Medical College

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タイトル別名
  • Case of Insulin Resistant Diabetes with

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A case of a19-year-old, non-obese female with insulin resistant diabetes mellitus and polycystic ovary syndrome was reported. The maximal insulin requirement attained360units per day, but a satisfactory control of diabetes did not follow. The patient's serum contained not only anti-insulin antibodies, but also possible anti-insulin receptor antibodies which were demonstrated by the 125I-insulin binding test using insulin receptors derived from human placental plasma membrane. The insulin resistance in this case was assumed to be caused primarily by possible blocking antibodies to insulin receptors and partly by anti-insulin antibodies because of the following observations. First, high serum free insulin (165μU/ml) without hypoglycemia indicates the presence of insulin resistance due to other factors than antiinsulin antibodies. Second, the titer of 125 I-insulin binding capacity of serum was not unusually higher than those seen in chronically insulin-treated diabetics. Third, immunologically heterospecies insulin (fish insulin) was also ineffective.<BR>The clinical features such as absence of ketoacidosis and association with polycystic ovary syndrome resemble those of an unique diabetic syndrome reported previously though acanthosis nigricans and endogenous hyperinsulinemia were not found in this case.<BR>Her insulin resistance remitted spontaneously and over the next18months'observation, her diabetes remained regulated without insulin therapy.

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