Lab Med Online.  2013 Jan;3(1):56-59. 10.3343/lmo.2013.3.1.56.

Unusually Elevated Serum Insulin Level in a Diabetic Patient during Recombinant Insulin Therapy

• Kim S
• Yun YM
• Hur M
• Moon HW

• KMID: 1845398
• DOI: http://doi.org/10.3343/lmo.2013.3.1.56

Abstract

Herein, we report a case of unusually elevated serum insulin level as a result of increased anti-insulin antibody (IA)-bound insulin after continuous subcutaneous insulin infusion therapy. Detecting free insulin (unbound IAs) levels after polyethylene glycol pre-treatment could be useful to assess functional insulin levels in diabetic patients receiving insulin therapy. The E170 insulin assay can estimate total insulin (bound IAs and free insulin) levels, but it does not measure the levels of exogenous insulin analogues.

Keyword

Insulin; Insulin antibodies; Insulin immunoassay; Insulin analogues; Cross-reactivity

MeSH Terms

Humans
Insulin
Insulin Antibodies
Polyethylene Glycols
Insulin
Insulin Antibodies
Polyethylene Glycols

Figure

• 

  Fig. 1 Structures of insulin, C-peptide, and exogenous recombinant insulin [2]. The dotted circle is the target for the recombinant human insulin analogues. The arrows indicate the antigenic determinant area (antibody recognition site).

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