KASMEJ
Kastamonu Medical Journal

Kastamonu Medical Journal regularly publishes internationally qualified issues in the field of Medicine in the light of up-to-date information.

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Case Report
A case of type 1 Diabetes mellitus unresponsive to insulin glulisine
Abstract
A 29-year-old man applied to the internal medicine outpatient clinic with fatigue and high plasma glucose levels. He had type 1 Diabetes Mellitus for 10 years and was using insulin glargine U300 and insulin glulisine for treatment. His glycosylated hemoglobin level was 16.7%, and he was hospitalized. Insulin doses were calculated as 1 unite/kg /day; glulisine 3×8 unit/day and glargine U300 1×18 unit/day were ordered. Although we increased the total insulin dosage to 1,5 units/kg/day, the plasma glucose measurements did not improve. The short-acting insulin analog was switched to insulin aspart based on the fact that insulin autoantibodies might cause this situation. On aspart treatment, the patient suffered from hypoglycemia with the same doses of glulisine. The occurrence of insulin autoantibodies against glulisine was confirmed clinically. Basal insulin dose was reduced to 20 units, and aspart 3x6 units/day was enough for plasma glucose control. Hyperglycemia due to autoantibodies against analog insulins is very rare. This rare case report must be kept in mind in hyperglycemic patients with a history of long-time analog insulin treatment.

Keywords : Hyperglycemia, type 1 Diabetes mellitus, insulin autoantibody

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Article available in :
Volume 2, Issue 4, 2022
Page : 135-137
https://doi.org/10.51271/KMJ-0075
Article Information
Received : 06 Eyl 2022
Accepted : 10 Eki 2022
Published : 29 Ara 2022
Corresponding Author :

Düriye Sıla Karagöz Özen: Samsun University, Samsun Research and Training Hospital, Clinic of Internal Medicine, Samsun, Turkey

[email protected]
Citation : Karagöz Özen DS, Ergin AU, Demir O, Demirağ MD. A case of type 1 diabetes mellitus unresponsive to insulin glulisine. Kastamonu Med J. 2022;2(4): 135-137.

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