ALTERED PHARMACOKINETICS OF INSULIN DUE TO INSULIN-ANTIBODIES

Background:The prevalence of insulin-antibodies in patients with diabe tes mellitus has recently decreased due to the usage of purified human insulin. In most patients,there are no clinical findings related to t hese antibodies. However, there are some patients with altered metabol ic control due to insulin antibodies. The typical clinical picture inv olves increased postprandial blood glucose levels as well as delayed h ypoglycemia. Case: We report on a 12 year old girl with insulin depend ent diabetes mellitus with alterations in insulin pharmacokinetics due to insulin antibodies. Although most of the daily insulin dose was ad ministered in the morning,the patient showed hyerglycemia during dayti me and nocturnal hypoglycemia. Frequent blood glucose measurement rule d out unrecognized hypoglycemia possibly causing the poor glycemic con trol. Insulin-antibodies were markedly elevated. Metabolic control was improved by decreasing the total dose of insulin and increasing the a mount of short acting insulin.