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Autoimmune Hypoglycemia in Type 1 Diabetes Mellitus
Jayakumar Ambigapathy1, Jayaprakash Sahoo, Sadishkumar Kamalanathan
1Department of Endocrinology, JIPMER, Pondicherry, India. Correspondence to: Dr Jayakumar Ambigapathy, Department of Endocrinology, JIPMER, Pondicherry 605 006, India. jeyakumarselvi@gmail.com.
Background:
Antibodies against exogenous insulin are common in type 1 diabetes mellitus patients. They can cause hypoglycemia, albeit uncommonly.
Case Characteristics:
A 14-year-old girl with type 1 diabetes mellitus presented with recurrent hypoglycemia.
Outcome:
High insulin, low C-peptide and raised insulin antibody levels documented during hypoglycemia. Plasmapheresis led to remission of hypoglycemia.
Message:
Antibodies to exogenous insulin should be considered as a cause of recurrent refractory hypoglycemia in type 1 diabetes mellitus patients.
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