Insulin Autoimmune Syndrome:Clinical Features and Management of 8 Cases
GAO Meihua
ZHOU Junfei
XU Xianjing
DUAN Hongyan
QIAN Peng
Abstract：Objective To summarize and analyze the clinical data of 8 cases of insulin autoimmune syndrome(IAS)patients to improve clinicians' awareness of IAS and reduce misdiagnosis and missed diagnosis in clinical practice.Methods The clinical data of 8 patients with IAS admitted to Henan Provincial People's Hospital from January 2018 to December 2023 were collected and analyzed,and the clinical characteristics of them were summarized.Results Among the 8 patients,including 4 males and 4 females,aged from 11 to 71 years,ranging from 0.5 to 17.0 months.IAS was mostly complicated with other autoimmune endocrine diseases,including 3 patients with autoimmune thyroid disease,2 patients with type 1 diabetes mellitus,and 3 patients with type 2 diabetes mellitus.One patient had a history of methimazole,three of exogenous insulin application and one of clopidogrel application.Eight patients were positive for insulin autoantibodies,and one patient was positive for insulin cell antibody and glutamyl decarboxylase antibody.The lowest blood glucose 1.1-2.9 mmol·L-1,insulin level 77.72-300 mIU·L-1at hypoglycemic episode,and C peptide 0.10-9.83 μg·L-1.In terms of treatment,all patients adjusted their diet to low carbohydrate,high fat and high protein diet,2 patients applied oral glucocorticoids,2 patients with type 1 diabetes changed insulin aspart to glulisine insulin,and all patients had improved the symptoms of hypoglycemia.Conclusion Mostly IAS patients occur in middle-aged and elderly people,often with autoimmune diseases.Sulfhydryl drugs and exogenous insulin were predisposing factors.IAS has a good prognosis,relieving hypoglycemia symptoms by removing triggers,adjusting diet,oral glycosidase inhibitors when necessary,oral glucocorticoids and other treatments.In insulin-dependent type 1 diabetes,glulisine insulin has been shown to relieve IAS hypoglycemia symptoms.
Keywords：insulin autoimmune syndromeinsulin autoantibodieshypoglycemia
Publication Date：2026-06-13
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：5( 1957-1961 )