Related Experiment Video
Updated: May 11, 2026
12:08
Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
[Recurrent hypoglycemia with elevated insulin levels in a 75-year-old man]
K C Grotemeyer1, V Zimmer, B Friesenhahn-Ochs
1Klinik für Innere Medizin II, Universitätsklinikum des Saarlandes, Kirrberger Str. 100, 66421, Homburg (Saar), Deutschland. katharina.grotemeyer@uks.eu
Der Internist
|May 7, 2013
Summary
Hirata syndrome, an immune condition causing recurrent hypoglycemia, involves autoantibodies against insulin. While often self-resolving, some patients need ongoing immunosuppressive treatment.
Area of Science:
- Endocrinology
- Immunology
- Metabolic Disorders
Background:
- Hirata syndrome is a rare immune-mediated disorder.
- It presents as recurrent hypoglycemia due to autoantibodies targeting insulin.
- Understanding its autoimmune basis is crucial for diagnosis.
Observation:
- A specific case of Hirata syndrome was observed.
- The patient presented with recurrent hypoglycemia.
- The autoimmune etiology was confirmed through autoantibody testing.
Findings:
- The patient required continuous immunosuppressive therapy.
- Spontaneous resolution, common in other cases, was not observed.
- This highlights the need for individualized treatment strategies.
Implications:
- Hirata syndrome management may necessitate long-term immunosuppression in some individuals.
- This finding expands the known clinical spectrum of Hirata syndrome.
- Further research into predicting and managing refractory cases is warranted.
Related Concept Videos
01:26Hypoglycemia
Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...
01:15Hypoglycemia and Glucagon
Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
01:29Hyperglycemia
Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
01:19Type I Diabetes III: Clinical Manifestations
Type 1 diabetes mellitus typically presents with rapid-onset symptoms due to the body’s inability to utilize glucose in the absence of insulin. Since insulin is required for glucose uptake into cells, its deficiency leads to hyperglycemia and cellular energy deprivation, resulting in characteristic clinical features.Polyuria and PolydipsiaOne of the earliest, most prominent symptoms is polyuria (excessive urination). When blood glucose concentrations rise above the renal threshold, the kidneys...
01:25Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis
Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated hypertension...
01:24Type II Diabetes II: Pathophysiology
PathophysiologyType 2 diabetes mellitus (T2DM ) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to impaired glucose homeostasis. It results from interactions among genetic predisposition, environmental factors, and metabolic stressors, such as overnutrition and a sedentary lifestyle.Insulin Resistance and Glucose DysregulationEarly T2DM involves insulin resistance in skeletal muscle, adipose tissue, and the liver.