Insulin and heparin challenge tests are useful for choosing an optimal insulin regimen in a case of subcutaneous insulin resistance. Issue 5 (6th May 2020)

• Record Type: Journal Article
• Authors: Nakamura, Yuko; Nagao, Mototsugu; Kobayashi, Shunsuke; Oba, Takeshi; Shuto, Yuki; Fukuda, Izumi; Oikawa, Shinichi; Sugihara, Hitoshi
• Is Part Of: Journal of diabetes investigation. Volume 11:Issue 5(2020)
• Page Start: 1370
• Page End: 1373
• Publication Date: 2020-05-06
• Subjects: Heparin -- Subcutaneous insulin resistance -- Type 1 diabetes; Diabetes -- Periodicals; Diabetes -- Research -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462005
• DOI: 10.1111/jdi.13266
• Languages: English
• ISSNs: 2040-1116

Abstract

Abstract: A 38‐year‐old woman with type 1 diabetes, whose fasting plasma glucose levels were >500 mg/dL under 176 U/day of subcutaneous insulin injection, was admitted to Nippon Medical School Hospital, Tokyo, Japan. When insulin was administered intravenously, she was able to maintain favorable glycemic control even under 24 U/day of regular insulin, showing that she was accompanied by subcutaneous insulin resistance. To choose an optimal insulin regimen, we carried out subcutaneous insulin challenge tests without or with heparin mixture, and found a cocktail of insulin lispro and heparin could reduce blood glucose levels markedly. As a consequence, she achieved favorable blood glucose control by continuous subcutaneous insulin infusion of the cocktail. In summary, the insulin and heparin challenge tests are useful for choosing an optimal insulin regimen in cases of subcutaneous insulin resistance. Abstract : Subcutaneous insulin resistance is defined as a lack of biological efficacy of subcutaneously injected insulin despite a retained efficacy of intravenous insulin infusion. Insulin and heparin challenge tests are useful for choosing an optimal insulin regimen in cases of subcutaneous insulin resistance.