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Hyperglycemia is a common phenomenon in hospitalized patients, exacerbated by infection, stress, or medications, and treated with subcutaneous or IV insulin. In rare cases, however, even very high doses of insulin are unable to control hyperglycemia. In these situations, clinicians will seek an alternative etiology of the resistance. We present a case of severe antibody-mediated insulin resistance requiring >1000 units of intravenous insulin daily successfully treated with U-500 insulin.
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Zapater et al. (2024) studied this question.
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