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Recurrent insulin resistance

B A Leatherdale, D A Ingram, K Dixon

Postgraduate Medical Journal

|January 1, 1980

Summary

This summary is machine-generated.

This case study highlights two instances of severe insulin resistance where high doses of soluble insulin were ineffective. Both episodes resolved with steroid therapy, suggesting an autoimmune component in this patient's diabetes management.

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Area of Science:

Endocrinology
Immunology
Metabolic Disorders

Background:

Insulin resistance is a common complication in diabetes mellitus, often managed with increased insulin dosage or alternative therapies.
Recurrent or severe cases may indicate underlying complex mechanisms beyond typical metabolic dysfunction.

Observation:

A patient experienced two distinct episodes of profound insulin resistance, requiring 980 units of soluble insulin daily without achieving glycemic control.
Serum insulin binding capacity was markedly elevated during the first episode but normalized during the second.

Findings:

Both episodes of insulin resistance demonstrated a significant response to corticosteroid administration.
The fluctuating levels of serum insulin binding capacity suggest a potential transient autoimmune process contributing to insulin resistance.

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Implications:

Corticosteroids may be a viable therapeutic option for specific cases of severe, refractory insulin resistance, particularly those with suspected autoimmune involvement.
Monitoring insulin binding capacity could aid in diagnosing and managing unusual forms of insulin resistance.