Skip to main content
Erschienen in: Acta Diabetologica 4/2010

01.12.2010 | Original Article

The importance of anti-insulin antibody in patients with type 1 diabetes mellitus treated with continuous subcutaneous insulin infusion or multiple daily insulin injections therapy

verfasst von: S. B. Sahin, S. Cetinkalp, A. G. Ozgen, F. Saygili, C. Yilmaz

Erschienen in: Acta Diabetologica | Ausgabe 4/2010

Einloggen, um Zugang zu erhalten

Abstract

To investigate the influence of two insulin administration modalities, continuous subcutaneous insulin infusion (CSII) and multiple daily insulin injections (MDI) therapy with insulin analogues, on the development of insulin antibodies (IAs) in patients with type 1 diabetes mellitus and to assess the impact of IAs on glucose control and hypoglycaemia. 96 patients with type 1 diabetes mellitus treated with CSII (n = 48) or MDI (n = 48) were included in the study. Age, duration of diabetes, A1c, preprandial and postprandial blood glucose and hypoglycaemic events were compared between IA positive and negative patients. IA levels were higher in the CSII group (% 24.6 ± 14.2) than the MDI group (% 13.2 ± 9.9). Duration of diabetes and age were not associated with IA positiveness. While A1c, preprandial blood glucose and the frequency of hypoglycaemic events were similar in two groups, postprandial blood glucose was lower in IA positive group (P = 0.03). Patients with type 1 diabetes mellitus treated with CSII with insulin analogues had higher IA levels when compared to MDI therapy. However, the development of IAs did not impair the glycaemic control.
Literatur
1.
Zurück zum Zitat Van Haeften TW (1989) Clinical significance of insulin antibodies in insulin-treated diabetic patients. Diabetes Care 12(9):641–648 (Review)CrossRefPubMed Van Haeften TW (1989) Clinical significance of insulin antibodies in insulin-treated diabetic patients. Diabetes Care 12(9):641–648 (Review)CrossRefPubMed
2.
Zurück zum Zitat Kurtz AB, Nabarro JD (1980) Circulating insulin-binding antibodies. Diabetologia 19(4):329–334 (Review)CrossRefPubMed Kurtz AB, Nabarro JD (1980) Circulating insulin-binding antibodies. Diabetologia 19(4):329–334 (Review)CrossRefPubMed
3.
Zurück zum Zitat Oak S, Phan TH, Gilliam LK, Hirsch IB, Hampe CS (2010) Animal insulin therapy induces a biased insulin antibody response that persists for years after introduction of human insulin. Acta Diabetol 47(2):131–135CrossRefPubMed Oak S, Phan TH, Gilliam LK, Hirsch IB, Hampe CS (2010) Animal insulin therapy induces a biased insulin antibody response that persists for years after introduction of human insulin. Acta Diabetol 47(2):131–135CrossRefPubMed
4.
Zurück zum Zitat Brange J, Owens DR, Kang S, Vølund A (1990) Monomeric insulins and their experimental and clinical implications. Diabetes Care 13(9):923–954CrossRefPubMed Brange J, Owens DR, Kang S, Vølund A (1990) Monomeric insulins and their experimental and clinical implications. Diabetes Care 13(9):923–954CrossRefPubMed
5.
Zurück zum Zitat Ottesen JL, Nilsson P, Jami J, Weilguny D, Dührkop M, Bucchini D et al (1994) The potential immunogenicity of human insulin and insulin analogues evaluated in a transgenic mouse model. Diabetologia 37(12):1178–1185CrossRefPubMed Ottesen JL, Nilsson P, Jami J, Weilguny D, Dührkop M, Bucchini D et al (1994) The potential immunogenicity of human insulin and insulin analogues evaluated in a transgenic mouse model. Diabetologia 37(12):1178–1185CrossRefPubMed
6.
Zurück zum Zitat Jaeger C, Winter S, Eckhard M, Hardt P, Brendel MD, Bretzel RG (2008) Binding characteristics and crossreactivity of insulin autoantibodies and insulin antibodies directed to three different insulin molecules. Acta Diabetol 45(3):191–194CrossRefPubMed Jaeger C, Winter S, Eckhard M, Hardt P, Brendel MD, Bretzel RG (2008) Binding characteristics and crossreactivity of insulin autoantibodies and insulin antibodies directed to three different insulin molecules. Acta Diabetol 45(3):191–194CrossRefPubMed
7.
Zurück zum Zitat Jeitler K, Horvath K, Berghold A, Gratzer TW, Neeser K, Pieber TR et al (2008) Continuous subcutaneous insulin infusion versus multiple daily insulin injections in patients with diabetes mellitus: systematic review and meta-analysis. Diabetologia 51(6):941–951 (Review)CrossRefPubMed Jeitler K, Horvath K, Berghold A, Gratzer TW, Neeser K, Pieber TR et al (2008) Continuous subcutaneous insulin infusion versus multiple daily insulin injections in patients with diabetes mellitus: systematic review and meta-analysis. Diabetologia 51(6):941–951 (Review)CrossRefPubMed
8.
Zurück zum Zitat Pickup JC, Sutton AJ (2008) Severe hypoglycaemia and glycaemic control in type 1 diabetes:meta-analysis of multiple daily insulin injections compared with continuous subcutaneous insulin infusion. Diabet Med 25(7):765–774 (Review)CrossRefPubMed Pickup JC, Sutton AJ (2008) Severe hypoglycaemia and glycaemic control in type 1 diabetes:meta-analysis of multiple daily insulin injections compared with continuous subcutaneous insulin infusion. Diabet Med 25(7):765–774 (Review)CrossRefPubMed
9.
Zurück zum Zitat Dahl-Jørgensen K, Torjesen P, Hanssen KF, Sandvik L, Aagenaes O (1987) Increase in insulin antibodies during continuous subcutaneous insulin infusion and multiple-injection therapy in contrast to conventional treatment. Diabetes 36(1):1–5CrossRefPubMed Dahl-Jørgensen K, Torjesen P, Hanssen KF, Sandvik L, Aagenaes O (1987) Increase in insulin antibodies during continuous subcutaneous insulin infusion and multiple-injection therapy in contrast to conventional treatment. Diabetes 36(1):1–5CrossRefPubMed
10.
Zurück zum Zitat Colquitt J, Royle P, Waugh N (2003) Are analogue insulins better than soluble in continuous subcutaneous insulin infusion? Results of a meta-analysis. Diabet Med (10):863–866 (Review) Colquitt J, Royle P, Waugh N (2003) Are analogue insulins better than soluble in continuous subcutaneous insulin infusion? Results of a meta-analysis. Diabet Med (10):863–866 (Review)
11.
Zurück zum Zitat Radermecker RP, Scheen AJ (2004) Continuous subcutaneous insulin infusion with shortacting insulin analogues or human regular insulin: efficacy, safety, quality of life, and cost-effectiveness. Diabetes Metab Res Rev 20(3):178–188 (Review)CrossRefPubMed Radermecker RP, Scheen AJ (2004) Continuous subcutaneous insulin infusion with shortacting insulin analogues or human regular insulin: efficacy, safety, quality of life, and cost-effectiveness. Diabetes Metab Res Rev 20(3):178–188 (Review)CrossRefPubMed
12.
Zurück zum Zitat Moisés RS, Sá JR, Chacra AR, Russo EM (1990) Relationship between insulin antibodies and metabolic control in type I diabetes mellitus. Braz J Med Biol Res 23(12):1243–1252PubMed Moisés RS, Sá JR, Chacra AR, Russo EM (1990) Relationship between insulin antibodies and metabolic control in type I diabetes mellitus. Braz J Med Biol Res 23(12):1243–1252PubMed
13.
Zurück zum Zitat Livneh A, Avraham H, Bistritzer T, Weisglass L, Theodor R, Sack J (1990) Deleterious effect of anti-insulin antibodies on diabetes control. Isr J Med Sci 26(1):11–15PubMed Livneh A, Avraham H, Bistritzer T, Weisglass L, Theodor R, Sack J (1990) Deleterious effect of anti-insulin antibodies on diabetes control. Isr J Med Sci 26(1):11–15PubMed
14.
Zurück zum Zitat Fernández Castañer M, Pérez M, Maravall J, Montaña E, Soler J (1996) Lack of relationship between insulin antibodies, metabolic control and insulin requirements in type 1 diabetes. Diabet Med 13(7):686–687CrossRefPubMed Fernández Castañer M, Pérez M, Maravall J, Montaña E, Soler J (1996) Lack of relationship between insulin antibodies, metabolic control and insulin requirements in type 1 diabetes. Diabet Med 13(7):686–687CrossRefPubMed
15.
Zurück zum Zitat Wredling R, Lins PE, Adamson U (1990) Prevalence of anti-insulin antibodies and its relation to severe hypoglycaemia in insulin-treated diabetic patients. Scand J Clin Lab Invest 50(5):551–557CrossRefPubMed Wredling R, Lins PE, Adamson U (1990) Prevalence of anti-insulin antibodies and its relation to severe hypoglycaemia in insulin-treated diabetic patients. Scand J Clin Lab Invest 50(5):551–557CrossRefPubMed
16.
Zurück zum Zitat Dozio N, Beretta A, Castiglioni M, Rosa S, Scavini M, Belloni C et al (1996) Insulin antibodies do not preclude optimization of metabolic control in women with IDDM during pregnancy. Diabetes Care 19(9):979–982CrossRefPubMed Dozio N, Beretta A, Castiglioni M, Rosa S, Scavini M, Belloni C et al (1996) Insulin antibodies do not preclude optimization of metabolic control in women with IDDM during pregnancy. Diabetes Care 19(9):979–982CrossRefPubMed
17.
Zurück zum Zitat Sakata S, Matsuda M, Komaki T, Miura K (1986) Effect of anti-insulin antibodies on glycemic control in insulin treated diabetic patients. Immunol Invest 15(8):791–799CrossRefPubMed Sakata S, Matsuda M, Komaki T, Miura K (1986) Effect of anti-insulin antibodies on glycemic control in insulin treated diabetic patients. Immunol Invest 15(8):791–799CrossRefPubMed
18.
Zurück zum Zitat Antony G, Cooper SG, Svejkar LC (1991) Continuous subcutaneous insulin infusion (CSII) and insulin antibodies in rabbits. Diabetes Res Clin Pract 12(1):41–51CrossRefPubMed Antony G, Cooper SG, Svejkar LC (1991) Continuous subcutaneous insulin infusion (CSII) and insulin antibodies in rabbits. Diabetes Res Clin Pract 12(1):41–51CrossRefPubMed
19.
Zurück zum Zitat de Beaufort CE, Houtzagers CM, Bruining GJ, Aarsen RS, den Boer NC, Grose WF et al (1989) Continuous subcutaneous insulin infusion (CSII) versus conventional injection therapy in newly diagnosed diabetic children: two-year follow-up of a randomized, prospective trial. Diabet Med 6(9):766–771CrossRefPubMed de Beaufort CE, Houtzagers CM, Bruining GJ, Aarsen RS, den Boer NC, Grose WF et al (1989) Continuous subcutaneous insulin infusion (CSII) versus conventional injection therapy in newly diagnosed diabetic children: two-year follow-up of a randomized, prospective trial. Diabet Med 6(9):766–771CrossRefPubMed
20.
Zurück zum Zitat Beck-Nielsen H, Richelsen B, Hasling C, Nielsen OH, Heding L, Sørensen NS (1984) Improved in vivo insulin effect during continuous subcutaneous insulin infusion in patients with IDDM. Diabetes 33(9):832–837CrossRefPubMed Beck-Nielsen H, Richelsen B, Hasling C, Nielsen OH, Heding L, Sørensen NS (1984) Improved in vivo insulin effect during continuous subcutaneous insulin infusion in patients with IDDM. Diabetes 33(9):832–837CrossRefPubMed
21.
Zurück zum Zitat Beck-Nielsen H, Richelsen B, Schwartz Sørensen N, Hother Nielsen O (1985) Insulin pump treatment: effect on glucose homeostasis, metabolites, hormones, insulin antibodies and quality of life. Diabetes Res 2(1):37–43PubMed Beck-Nielsen H, Richelsen B, Schwartz Sørensen N, Hother Nielsen O (1985) Insulin pump treatment: effect on glucose homeostasis, metabolites, hormones, insulin antibodies and quality of life. Diabetes Res 2(1):37–43PubMed
22.
Zurück zum Zitat Henrivaux P, Daubresse JC, Scheen A, Luyckx A, Lefèbvre PJ (1985) Effect of long- term continuous subcutaneous insulin infusion (CSII) on serum anti- insulin antibodies: comparison between pocine and semisynthetic human insulin. Diabetes Res Clin Pract (Suppl 1): S234–S235 Henrivaux P, Daubresse JC, Scheen A, Luyckx A, Lefèbvre PJ (1985) Effect of long- term continuous subcutaneous insulin infusion (CSII) on serum anti- insulin antibodies: comparison between pocine and semisynthetic human insulin. Diabetes Res Clin Pract (Suppl 1): S234–S235
23.
Zurück zum Zitat Scheen AJ, Henrivaux P, Jandrain B, Lefebvre PJ (1986) Anti-insulin antibodies and metabolic deterioration after interruption of continuous subcutaneous insulin infusion. Diabetes Care 9(6):673–674PubMed Scheen AJ, Henrivaux P, Jandrain B, Lefebvre PJ (1986) Anti-insulin antibodies and metabolic deterioration after interruption of continuous subcutaneous insulin infusion. Diabetes Care 9(6):673–674PubMed
24.
Zurück zum Zitat Fineberg SE, Kawabata TT, Finco-Kent D, Fountaine RJ, Finch GL, Krasner AS (2007) Immunological responses to exogenous insulin. Endocr Rev 28(6):625–652 (Epub 2007 Sep 4 Review) Fineberg SE, Kawabata TT, Finco-Kent D, Fountaine RJ, Finch GL, Krasner AS (2007) Immunological responses to exogenous insulin. Endocr Rev 28(6):625–652 (Epub 2007 Sep 4 Review)
25.
Zurück zum Zitat Chawla AS, Hinberg I, Blais P, Johnson D (1985) Aggregation of insulin, containing surfactants, in contact with different materials. Diabetes 34(5):420–424CrossRefPubMed Chawla AS, Hinberg I, Blais P, Johnson D (1985) Aggregation of insulin, containing surfactants, in contact with different materials. Diabetes 34(5):420–424CrossRefPubMed
26.
Zurück zum Zitat Robbins DC, Cooper SM, Fineberg SE, Mead PM (1987) Antibodies to covalent aggregates of insulin in blood of insulin-using diabetic patients. Diabetes 36(7):838–841CrossRefPubMed Robbins DC, Cooper SM, Fineberg SE, Mead PM (1987) Antibodies to covalent aggregates of insulin in blood of insulin-using diabetic patients. Diabetes 36(7):838–841CrossRefPubMed
27.
Zurück zum Zitat Miller RA (1996) The aging immune system: primer and prospectus. Science 273(5271):70–74 (Review)CrossRefPubMed Miller RA (1996) The aging immune system: primer and prospectus. Science 273(5271):70–74 (Review)CrossRefPubMed
28.
Zurück zum Zitat Fineberg SE, Galloway JA, Fineberg NS, Goldman J (1983) Effects of species of origin, purification levels, and formulation on insulin immunogenicity. Diabetes 32(7):592–599CrossRefPubMed Fineberg SE, Galloway JA, Fineberg NS, Goldman J (1983) Effects of species of origin, purification levels, and formulation on insulin immunogenicity. Diabetes 32(7):592–599CrossRefPubMed
29.
Zurück zum Zitat Fineberg SE, Kawabata T, Finco-Kent D, Liu C, Krasner A (2005) Antibody response to inhaled insulin in patients with type 1 or type 2 diabetes. An analysis of initial phase II and III inhaled insulin (Exubera) trials and a two-year extension trial. J Clin Endocrinol Metab 90(6):3287–3294CrossRefPubMed Fineberg SE, Kawabata T, Finco-Kent D, Liu C, Krasner A (2005) Antibody response to inhaled insulin in patients with type 1 or type 2 diabetes. An analysis of initial phase II and III inhaled insulin (Exubera) trials and a two-year extension trial. J Clin Endocrinol Metab 90(6):3287–3294CrossRefPubMed
30.
Zurück zum Zitat Francis AJ, Hanning I, Alberti KG (1985) The influence of insulin antibody levels on the plasma profiles and action of subcutaneously injected human and bovine short acting insulins. Diabetologia 28(6):330–334CrossRefPubMed Francis AJ, Hanning I, Alberti KG (1985) The influence of insulin antibody levels on the plasma profiles and action of subcutaneously injected human and bovine short acting insulins. Diabetologia 28(6):330–334CrossRefPubMed
31.
Zurück zum Zitat Van Haeften TW, Heiling VJ, Gerich JE (1987) Adverse effects of insulin antibodies on postprandial plasma glucose and insulin profiles in diabetic patients without immune insulin resistance. Implications for intensive insulin regimens. Diabetes 36(3):305–309CrossRefPubMed Van Haeften TW, Heiling VJ, Gerich JE (1987) Adverse effects of insulin antibodies on postprandial plasma glucose and insulin profiles in diabetic patients without immune insulin resistance. Implications for intensive insulin regimens. Diabetes 36(3):305–309CrossRefPubMed
32.
Zurück zum Zitat Bistritzer T, Sack J, Theodor R, Weissglass L, Ben-Bassat I, Lahav M (1984) Correlation between HbA1c, purified insulins, diabetic control, and insulin antibodies in diabetic children. Horm Res 20(3):178–185CrossRefPubMed Bistritzer T, Sack J, Theodor R, Weissglass L, Ben-Bassat I, Lahav M (1984) Correlation between HbA1c, purified insulins, diabetic control, and insulin antibodies in diabetic children. Horm Res 20(3):178–185CrossRefPubMed
33.
Zurück zum Zitat Goswami R, Jaleel A, Kochupillai NP (2000) Insulin antibody response to bovine insulin therapy: functional significance among insulin requiring young diabetics in India. Diabetes Res Clin Pract 49(1):7–15CrossRefPubMed Goswami R, Jaleel A, Kochupillai NP (2000) Insulin antibody response to bovine insulin therapy: functional significance among insulin requiring young diabetics in India. Diabetes Res Clin Pract 49(1):7–15CrossRefPubMed
34.
Zurück zum Zitat Gonen B, Goldman J, Baldwin D, Goldberg RB, Ryan WG, Blix PM et al (1979) Metabolic control in diabetic patients. Effect of insulin-secretory reserve (measured by plasma C-peptide levels) and circulating insulin antibodies. Diabetes 28(8):749–753CrossRefPubMed Gonen B, Goldman J, Baldwin D, Goldberg RB, Ryan WG, Blix PM et al (1979) Metabolic control in diabetic patients. Effect of insulin-secretory reserve (measured by plasma C-peptide levels) and circulating insulin antibodies. Diabetes 28(8):749–753CrossRefPubMed
35.
Zurück zum Zitat Hübinger A, Becker A, Gries FA (1988) Total insulin levels in type 1 diabetic patients with insulin antibodies and their effect on insulin requirement and metabolic control. Diabetes Res 7(2):65–69PubMed Hübinger A, Becker A, Gries FA (1988) Total insulin levels in type 1 diabetic patients with insulin antibodies and their effect on insulin requirement and metabolic control. Diabetes Res 7(2):65–69PubMed
36.
Zurück zum Zitat Kabadi UM, Birkenholz M (1992) Metabolic control following transfer from mixed bovine-porcine insulin to human insulin in subjects with IDDM: influence of the presence of insulin antibodies. Diabetes Res 19(4):187–193PubMed Kabadi UM, Birkenholz M (1992) Metabolic control following transfer from mixed bovine-porcine insulin to human insulin in subjects with IDDM: influence of the presence of insulin antibodies. Diabetes Res 19(4):187–193PubMed
37.
Zurück zum Zitat Virgili F, Frigato F, Magnanini PG, Coronel GA, Iavicoli M (1988) Reduction in insulin antibodies 42 months after transfer from porcine to human monocomponent insulins. Diabetes Res 9(1):19–20PubMed Virgili F, Frigato F, Magnanini PG, Coronel GA, Iavicoli M (1988) Reduction in insulin antibodies 42 months after transfer from porcine to human monocomponent insulins. Diabetes Res 9(1):19–20PubMed
38.
Zurück zum Zitat Walford S, Allison SP, Reeves WG (1982) The effect of insulin antibodies on insulin dose and diabetic control. Diabetologia 22(2):106–110CrossRefPubMed Walford S, Allison SP, Reeves WG (1982) The effect of insulin antibodies on insulin dose and diabetic control. Diabetologia 22(2):106–110CrossRefPubMed
39.
Zurück zum Zitat Asplin CM, Hartog M, Goldie DJ, Alberti KG, Smythe P, Binder C et al (1978) A comparison between diabetics receiving a high or low daily insulin dosage. Horm Metab Res 10(5):365–369CrossRefPubMed Asplin CM, Hartog M, Goldie DJ, Alberti KG, Smythe P, Binder C et al (1978) A comparison between diabetics receiving a high or low daily insulin dosage. Horm Metab Res 10(5):365–369CrossRefPubMed
40.
Zurück zum Zitat Kerp L, Kasemir H (1976) High and low affinity insulin antibodies. Acta Endocrinol Suppl (Copenh) 205:211–222 Kerp L, Kasemir H (1976) High and low affinity insulin antibodies. Acta Endocrinol Suppl (Copenh) 205:211–222
41.
Zurück zum Zitat Keilacker H, Rjasanowski I, Ziegler M, Michaelis D, Woltanski KP, Besch W (1982) Insulin antibodies in juvenile diabetes mellitus. Correlations to diabetic stability, insulin requirement and duration of insulin treatment. Horm Metab Res 14(5):227–232CrossRefPubMed Keilacker H, Rjasanowski I, Ziegler M, Michaelis D, Woltanski KP, Besch W (1982) Insulin antibodies in juvenile diabetes mellitus. Correlations to diabetic stability, insulin requirement and duration of insulin treatment. Horm Metab Res 14(5):227–232CrossRefPubMed
42.
Zurück zum Zitat Kim MR, Sheeler LR, Mansharamani N, Haug MT, Faiman C, Gupta MK (1997) Insulin antibodies and hypoglycemia in diabetic patients. Can a quantitative analysis of antibody binding predict the risk of hypoglycemia? Endocrine 6(3):285–291CrossRefPubMed Kim MR, Sheeler LR, Mansharamani N, Haug MT, Faiman C, Gupta MK (1997) Insulin antibodies and hypoglycemia in diabetic patients. Can a quantitative analysis of antibody binding predict the risk of hypoglycemia? Endocrine 6(3):285–291CrossRefPubMed
43.
Zurück zum Zitat Radermecker RP, Renard E, Scheen AJ (2009) Circulating insulin antibodies: influence of continuous subcutaneous or intraperitoneal insulin infusion, and impact on glucose control. Diabetes Metab Res Rev 25(6):491–501CrossRefPubMed Radermecker RP, Renard E, Scheen AJ (2009) Circulating insulin antibodies: influence of continuous subcutaneous or intraperitoneal insulin infusion, and impact on glucose control. Diabetes Metab Res Rev 25(6):491–501CrossRefPubMed
44.
Zurück zum Zitat Koyama R, Nakanishi K, Kato M, Yamashita S, Kuwahara H, Katori H (2005) Hypoglycemia and hyperglycemia due to insulin antibodies against therapeutic human insulin: treatment with double filtration plasmapheresis and prednisolone. Am J Med Sci 329(5):259–264CrossRefPubMed Koyama R, Nakanishi K, Kato M, Yamashita S, Kuwahara H, Katori H (2005) Hypoglycemia and hyperglycemia due to insulin antibodies against therapeutic human insulin: treatment with double filtration plasmapheresis and prednisolone. Am J Med Sci 329(5):259–264CrossRefPubMed
45.
Zurück zum Zitat Matsuyoshi A, Shimoda S, Tsuruzoe K, Taketa K, Chirioka T, Sakamoto F et al (2006) A case of slowly progressive type 1 diabetes with unstable glycemic control caused by unusual insulin antibody and successfully treated with steroid therapy. Diabetes Res Clin Pract 72(3):238–243CrossRefPubMed Matsuyoshi A, Shimoda S, Tsuruzoe K, Taketa K, Chirioka T, Sakamoto F et al (2006) A case of slowly progressive type 1 diabetes with unstable glycemic control caused by unusual insulin antibody and successfully treated with steroid therapy. Diabetes Res Clin Pract 72(3):238–243CrossRefPubMed
46.
Zurück zum Zitat Suzuki K, Hirayama S, Ito S (1997) A case of a non-insulin dependent diabetic patient with regular spontaneous hypoglycemic attacks, which were due to insulin-binding antibodies induced by human insulin therapy. Tohoku J Exp Med 182(2):163–173CrossRefPubMed Suzuki K, Hirayama S, Ito S (1997) A case of a non-insulin dependent diabetic patient with regular spontaneous hypoglycemic attacks, which were due to insulin-binding antibodies induced by human insulin therapy. Tohoku J Exp Med 182(2):163–173CrossRefPubMed
47.
Zurück zum Zitat Asplin CM, Hartog M, Goldie DJ (1978) The relationship between circulating free and bound insulin, insulin antibodies, insulin dosage and diabetic control in insulin treated diabetics. Acta Endocrinol (Copenh) 87(2):330–338 Asplin CM, Hartog M, Goldie DJ (1978) The relationship between circulating free and bound insulin, insulin antibodies, insulin dosage and diabetic control in insulin treated diabetics. Acta Endocrinol (Copenh) 87(2):330–338
Metadaten
Titel
The importance of anti-insulin antibody in patients with type 1 diabetes mellitus treated with continuous subcutaneous insulin infusion or multiple daily insulin injections therapy
verfasst von
S. B. Sahin
S. Cetinkalp
A. G. Ozgen
F. Saygili
C. Yilmaz
Publikationsdatum
01.12.2010
Verlag
Springer Milan
Erschienen in
Acta Diabetologica / Ausgabe 4/2010
Print ISSN: 0940-5429
Elektronische ISSN: 1432-5233
DOI
https://doi.org/10.1007/s00592-010-0221-5

Weitere Artikel der Ausgabe 4/2010

Acta Diabetologica 4/2010 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.