Insulin autoimmune syndrome is a rare cause of spontaneous hypoglycaemia in non-diabetic individuals that can be successfully managed with dietary modification, acarbose, and glucocorticoids.
Checking insulin antibodies may avert unnecessary localization studies; leaves open whether diet plus acarbose and steroids is reliably first-line.
Insulin autoimmune syndrome (IAS) is a rare cause of hypoglycaemia, characterised by recurrent hypoglycaemic episodes secondary to insulin autoantibodies in individuals who are not exposed to exogenous insulin. We are reporting a case of IAS in a 64-year-old gentleman, who presented with predominant postprandial hypoglycaemic episodes. On biochemical evaluation, he was found to have hyperinsulinemic hypoglycaemia. Localisation studies with MRI abdomen and endoscopic ultrasound (EUS) were negative for pancreatic tumour. Tests sent for insulin antibody levels were elevated. The patient was treated with frequent meals, acarbose and glucocorticoids. Patient condition improved and did not experience hypoglycaemia on follow-up.
No takes yet. Share an insight, caveat, or question.
Ravindra et al. (2020) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: