• Journal of Yeungnam Medical Science
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• v.34 no.1
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• pp.115-118
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• 2017

Insulin autoimmune syndrome (IAS) is characterized by spontaneous hypoglycemia, extremely high serum insulin levels, and high titers of autoantibodies against endogenous insulin, in the absence of exogenous insulin injection. IAS often occurs following exposure to sulfhydryl-containing drugs, including alpha-lipoic acid (ALA). A 30-year-old woman without diabetes visited our outpatient clinic with recurrent hypoglycemia. She had been taken ALA for weight reduction since 3 weeks ago. Further hypoglycemia work up revealed very high insulin levels, C-Peptide levels and positive insulin antibodies. And conventional imaging examinations were negative for insulinoma or other pancreatic tumors. Finally, the diagnosis of Insulin autoimmune syndrome (IAS) was made. Following the cessation of ALA, hypoglycemia improved, with no medication, and the patient experienced no further hypoglycemic attacks over the next month. The use of ALA as a nutritional supplement is increasing. We report a case of IAS associated with ALA in a non-diabetic patient.

• Diabetes and Metabolism Journal
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• v.42 no.6
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• pp.451-464
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• 2018

Latent autoimmune diabetes in adults (LADA) is a heterogeneous disease characterized by a less intensive autoimmune process and a broad clinical phenotype compared to classical type 1 diabetes mellitus (T1DM), sharing features with both type 2 diabetes mellitus (T2DM) and T1DM. Since patients affected by LADA are initially insulin independent and recognizable only by testing for islet-cell autoantibodies, it could be difficult to identify LADA in clinical setting and a high misdiagnosis rate still remains among patients with T2DM. Ideally, islet-cell autoantibodies screening should be performed in subjects with newly diagnosed T2DM, ensuring a closer monitoring of those resulted positive and avoiding treatment of hyperglycaemia which might increase the rate of ${\beta}-cells$ loss. Thus, since the autoimmune process in LADA seems to be slower than in classical T1DM, there is a wider window for new therapeutic interventions that may slow down ${\beta}-cell$ failure. This review summarizes the current understanding of LADA, by evaluating data from most recent studies, the actual gaps in diagnosis and management. Finally, we critically highlight and discuss novel findings and future perspectives on the therapeutic approach in LADA.

• Journal of the East Asian Society of Dietary Life
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• v.17 no.2
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• pp.205-212
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• 2007

This study was designed to investigate a natural medicinal multi-plants extract (BG515), which consisted of multi extracts of Mori folium, Rehmannia glutinosa Liboschitz, Dioscorea japonica, Lycii fructus, and Astragalus radix, on blood glucose, insulin levels, and serum malondialdehyde (MDA) concentrations in streptozotocin-induced diabetic rats. Streptozotocin (STZ) induces a type 1 diabetes mellitus in rats. Type 1 is usually characterized by the presence of islet cell autoantibodies (ICA), autoantibodies to insulin (IAA), and autoantiboides to glutamic acid decarboxylase (GAD), which identify the autoimmune process that leads to $\beta-cell$ destruction. Thirty-five male Sprague-Dawley (SD) rats weighing $150\sim170g$ each (6 weeks old) were randomly divided into one control (Group A) and 4 STZ-induced diabetic groups, and were subjected to one of the following treatment for 12 weeks. Groups A and B were fed basal diets and Group C, D, and E received the same diets as groups A and B, but with supplements of 150 mg/kg, 300 mg/kg, and 600 mg/kg of BG515 orally for 12 weeks, respectively. Diabetes was induced in Groups B, C, D, and E by intravenous injection of 45 mg/kg of STZ per body weight in sodium citrate buffer (pH 4.5) via the tail vein. In the BG515 groups, we found increases in serum insulin levels, compared to the STZ-control group, but these data were not significant. In contrast, blood glucose and serum MDA concentrations decreased in the BG515 groups compare to the STZ-control group. At the 5th week, in all the BG515 administered groups, there were decreases in serum blood glucose levels compared to the STZ- control group, and this activity was very strong in the BG515-1 group at the 12th week. These results suggest that natural bio-complex compounds (BG515) may slightly suppress STZ-induced changes in serum MDA concentration via the maintenance of serum insulin levels, due to the prevention of $\beta-cell$ and glucagon destruction by STZ.

• Clinical and Experimental Pediatrics
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• v.53 no.3
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• pp.414-419
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• 2010

Purpose : The purpose of this study was to determine whether there is any difference in the clinical and laboratory characteristics of patients with autoantibody-positive and patients with autoantibody-negative type 1 diabetes at initial presentation. Methods : We analyzed 96 patients under 18 years of age with newly diagnosed type 1 diabetes. One or both of the pancreatic autoantibodies-glutamic acid decarboxylase autoantibodies (GADA) and insulin autoantibody (IAA)-were measured in all patients, and we reviewed clinical and laboratory characteristics according to the presence of these autoantibodies. Results : GADA was examined in 48 of 87 patients, and 55.2% of patients were positive. IAA was checked in 88 patients, and 39.8% were positive. Both GADA and IAA were measured in 83 patients, and 22.8% had both antibodies. The patients who had one or both autoantibodies (autoantibody-positive group) were younger than those not having any autoantibody (autoantibody-negative group). The autoantibody-positive group had lower BMI, corrected sodium level, and serum effective osmolarity, compared to the autoantibody-negative group (P <0.05). Similar differences were found between the GADA-positive and GADA-negative groups. However, there were no significant differences between the IAA-positive and IAA-negative groups. Conclusion : The prevalence of pancreatic autoantibodies was significantly higher in the under-6 years age group than in the other age groups. These findings suggest that measurement of autoantibodies at the initial diagnosis of diabetes is very useful for detecting immune-mediated type 1 diabetes and providing intensive insulin therapy, especially in younger children.