Insulin Antibodies in Juvenile Diabetes Mellitus

Keilacker, H; Rjasanowski, I; Ziegler, M; D, Michaelis; Woltanski, K.-P.; Besch, W

doi:10.1055/s-2007-1018979

Cited by 13 publications

(2 citation statements)

References 10 publications

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“…We did not measure insulin antibodies, which could be an additional cause of hypoglycaemia in our patient. Non-neutralizing insulin-binding antibodies induced by exogenous insulin may prolong the half-life of insulin in the circulation, thereby lowering insulin requirement [10, 11]. Insulin binding to antibodies has been considered as a risk factor for inexplicable hypoglycaemia in T1DM children [12].…”

Section: Discussionmentioning

confidence: 99%

Recurrent hypoglycaemia in type-1 diabetes mellitus may unravel the association with Addison’s disease: a case report

et al. 2014

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BackgroundPrimary adrenocortical insufficiency or Addison’s disease is caused by a progressive destruction of the adrenal cortex, resulting into a reduction of glucocorticoids, mineralocorticoids, and androgens. Autoimmune Addison’s disease is the most common etiological form, accounting for about 80% of all cases.Case presentationWe describe the case of a 16-year-old Caucasian boy affected by type-1 diabetes mellitus and autoimmune thyroiditis, who experienced recurrent hypoglycaemia as presenting symptom of Addison’s disease.ConclusionsHypoglycaemia is not a common presenting feature of Addison’s disease, both in patients with type-1 diabetes mellitus and in non-diabetic patients. However, hypoglycaemia may occur in association with primary and secondary glucocorticoid deficiency as a result of an enhanced insulin sensitivity. Hypoglycaemia is the most common acute complication of insulin therapy in patients with type-1 diabetes mellitus. Addison’s disease has been described in approximately 0.5% of patients with type-1 diabetes mellitus, being more frequent in females and occurring in middle-aged patients. An association among type-1 diabetes mellitus, autoimmune thyroiditis, and Addison’s disease is found in the “Schmidt’s syndrome”, a rare disorder that may occur in the paediatric age. Our case suggests that the presence of Addison’s disease should be taken into consideration in patients with type-1 diabetes mellitus and frequent episodes of hypoglycaemia. We wish to highlight that there are no specific indications to screen for the association between Addison’s disease and type-1 diabetes mellitus, although an early diagnosis of Addison’s disease in diabetic patients would prevent the morbidity and potential mortality of this association.

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Section: Discussionmentioning

confidence: 99%

Recurrent hypoglycaemia in type-1 diabetes mellitus may unravel the association with Addison’s disease: a case report

et al. 2014

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“…No significant differences of insulin need existed between the two groups at each time of investigation. Plasma insulin binding was measured by the use of I-monoiodo pork insulin and the charcoal-dextrane separation technique (Keilacker et al 1982). Estimates of antibodies' affinity, indicated by the equilibrium dissociation constant K, and binding site concentrations q were determined according to Keilacker, Besch, Woltanski, Diaz-Alonso, Kohnert and Ziegler (1987).…”

Section: Methodsmentioning

confidence: 99%