Background The application of exogenous insulin is a critical part of treatment of diabetes. However, it may cause immune response and induce exogenous insulin antibody syndrome (EIAS).
Objective To investigate the clinical characteristics and treatment of EIAS.
Methods The clinical characteristics, treatment and prognosis of 3 patients with EIAS were analyzed.
Results The patients with type 2 diabetes were all treated with exogenous insulin. Their serum insulin auto-antibodies (IAA) were all positive. Case 1 presented with hyperglycemia and ketosis, his insulin dosage decreased and blood glucose was well controlled after plasma exchange and immunosuppression therapy; The other 2 patients manifested with alternation of hyperglycemia and hypoglycemia. The blood glucose was well controlled after changing insulin to oral hypoglycemic agents. The serum insulin level in case 1 and case 3 was within the normal range, and that in case 2 was abnormally elevated.
Conclusion The diabetic patients treated with exogenous insulin may suffer from EIAS, their IAA can be positive but the clinical manifestations and insulin levels are different. The main treatment strategies are changing insulin to oral hypoglycemic drugs and control diet, plasma exchange can be used for severe cases.
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