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-Lipoic Acid and Insulin Autoimmune Syndrome

¹ Ishida Clinic, Kobe, Japan
² Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, Kobe University, Kobe, Japan

Address correspondence and reprint requests to Wataru Ogawa, Division of Diabetes, Metabolism, and Endocrinology, Internal Medicine, Kobe University, Kobe 650-0017, Japan. E-mail: ogawa@med.kobe-u.ac.jp

Abbreviations: ALA, -lipoic acid • OGTT, oral glucose tolerance test

The first 20% of the full text of this article appears below.

	INTRODUCTION

 
Insulin autoimmune syndrome, a relatively rare cause of hypoglycemia, is characterized by the production of autoantibodies to insulin in individuals who have not previously been injected with this hormone (1). Drug-induced autoimmunity appears to be important in the pathogenesis of this syndrome, given that 50% of affected individuals have taken certain drugs, most of which (such as methimazole, -mercaptopropionyl glycine, or glutathione) contain the sulfydryl group, before its onset (1). We now report a case of insulin autoimmune syndrome likely induced by -lipoic acid (ALA), a reduced form of which contains the sulfydryl group (2).

	RESEARCH DESIGN AND METHODS—

 
A 32-year-old Japanese woman visited Ishida Clinic on 1 June 2005 because of a feeling of weariness before lunch and dinner. This symptom, which first occurred on 23 May 2005, was relieved by ingestion of the meal. The patient had been well until the onset of the preprandial weariness, had never been injected with insulin, and had no family history of metabolic, hormonal, or autoimmune diseases. Her weight was 60 kg and height 155.4 cm.

The patient's plasma glucose levels during a 75-g oral glucose tolerance test (OGTT) (59, 154, 207, and 227 mg/dl at 0, 30, 60, and 120 min after glucose ingestion, respectively) performed on 3 June 2005 were consistent with a diagnosis of diabetes, whereas her A1C level was low (4.5%). Serum . . . [Full Text of this Article]

	RESULTS—

 

	CONCLUSIONS—

 

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