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A type 2 diabetic patient with liver dysfunction due to human insulin
1Third Department of Internal Medicine, Yamanashi Medical University, Tamaho, Yamanashi, Japan. tawatam@res.yamanashi-med.ac.jp
Diabetes Research and Clinical Practice
|May 16, 2000
Summary
This study found that human insulin may cause liver dysfunction in some patients with type 2 diabetes. Close monitoring of liver function tests is recommended during insulin therapy.
Area of Science:
- Endocrinology
- Hepatology
Background:
- Type 2 diabetes mellitus management often involves insulin therapy.
- Maintaining optimal glycemic control is crucial for preventing diabetic complications.
Observation:
- A 45-year-old male with type 2 diabetes experienced elevated liver enzymes (gamma-GTP, aminotransferases) after starting insulin (Penfil 30R).
- Liver enzymes normalized upon insulin discontinuation and re-elevated upon re-initiation.
- Further challenges with a different human insulin (Humalin R) also led to elevated aminotransferases.
- Lymphocyte stimulation tests were negative for all tested insulin preparations.
Findings:
- The patient's liver dysfunction was temporally associated with human insulin administration.
- The lymphocyte stimulation test did not indicate an allergic reaction as the cause.
Implications:
- Human insulin itself may be a potential cause of drug-induced liver injury.
- Clinicians should consider monitoring liver function tests in patients initiating insulin therapy.
- Further research is needed to elucidate the mechanisms of insulin-induced hepatotoxicity.