Liraglutide improved glycaemic instability in a patient with diabetes with insulin antibodies.
Liraglutide improved glycaemic instability in a patient with diabetes with insulin antibodies.
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DOI：
10.1136/bcr-2016-216028
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发表时间：
2016-07-20
期刊：
影响因子：
0.9
通讯作者：
Takeda, Jun
中科院分区：
文献类型：
--
作者：
Kato, Takehiro;Iizuka, Katsumi;Takeda, Jun
胰岛素抗体有时会导致葡萄糖不稳定。一位52岁男性患者因糖尿病入院治疗。从2003年10月开始，他接受胰岛素治疗自身免疫性胰腺炎和糖尿病，但他的血红蛋白A1 c（HbA 1c）水平逐渐达到8.0%（64 mmol/mol IFCC）。 2010年1月，甘精胰岛素和门冬胰岛素上市。2010年4月，胰岛素抗体滴度升至>13.6 U/mL。 2010年7月，治疗改为甘精胰岛素、二甲双胍和米格列醇。2011年11月，对甘精胰岛素、二甲双胍和西格列汀进行了进一步变更。胰岛素抗体滴度逐渐下降，但HbA 1c水平仍然很高。2014年11月，引入利拉鲁肽和甘精胰岛素，尽管胰岛素抗体滴度增加（从32.6 U/mL增加至>50.0 U/mL），但HbA 1c水平显著降低至7.5%（58 mmol/mol IFCC）。 利拉鲁肽成功改善了胰岛素抗体引起的血液不稳定性，而不调节血浆胰岛素水平。
Insulin antibodies sometimes cause glucose instability. A 52-year-old male patient was admitted to our department for the treatment of diabetes mellitus. From October 2003, he received insulin treatment for autoimmune pancreatitis and diabetes mellitus, but his hemoglobin A1c (HbA1c) levels gradually reached 8.0% (64 mmol/mol IFCC). In January 2010, insulin glargine and insulin aspart were introduced. In April 2010, the insulin antibody titre rose to >13.6 U/mL. In July 2010, treatment was changed to insulin glargine, metformin and miglitol. In November 2011, a further change to insulin glargine, metformin and sitagliptin was made. The insulin antibody titres gradually decreased, but HbA1c levels remained high. In November 2014, liraglutide and insulin glargine were introduced and the HbA1c levels decreased dramatically to 7.5% (58 mmol/mol IFCC) despite increasing insulin antibody titres (from 32.6 to >50.0 U/mL). Liraglutide successfully improved glycaemic instability due to insulin antibodies without modulating plasma insulin levels.