Insulin autoimmune syndrome: A rare cause of hypoglycemia

Journal of Family Medicine and Primary Care
Tejas M MaheshwariBhagwani Bai Maheshwari

Abstract

Insulin autoimmune syndrome (IAS) is a rare cause of hyperinsulinemic hypoglycemia. It is due to autoantibodies to endogenous insulin in person who has never been sensitized to insulin by injections. IAS is a third leading cause of spontaneous hypoglycemia in Japan and it is increasingly being recognized worldwide in non-Asian population. However, we report a case of IAS in Asian male. A certain class of medication called sulfhydryl compounds have been shown to sometimes cause IAS. Recently a compound called alpha lipoic acid (ALA) has been associated with an increased risk of developing IAS. ALA is sometimes used for dieting purposes. We report a case of 36-year-old Indian male presented with symptoms of dizziness and feeling of hunger with sweating, noted to have low blood sugars on multiple occasions. There is a definite history of ALA compound intake as dietary supplements with multivitamins. Subsequently, he was diagnosed as a case of recurrent hypoglycemia from IAS due to ALA intake and managed accordingly.

References

Nov 1, 1990·Diabetes Research and Clinical Practice·S Takayama-HasumiY Hirata
Sep 29, 1999·Endocrinology and Metabolism Clinics of North America·J B Redmon, F Q Nuttall
Dec 17, 2008·Diabetes Research and Clinical Practice·Yasuko UchigataYasuhiko Iwamoto
Jan 10, 2020·Case Reports in Endocrinology·Einas Alrashidi, Thamer Alessa

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