Enhancement of postprandial endogenous insulin secretion rather than exogenous insulin injection ameliorated insulin antibody-induced unstable diabetes: a case report.

Kaneko K, Satake C, Izumi T, Tanaka M, Yamamoto J, Asai Y, Sawada S, Imai J, Yamada T, Katagiri H

BMC endocrine disorders8 Jan 2019Cited by 9 (Europe PMC)

PMID30621663PMCIDPMC6325663DOI10.1186/s12902-018-0326-3PepBankPUB-30621663

Summary

BackgroundInsulin injection, especially with insulin analogs, occasionally induces the production of insulin antibodies with high binding capacity and low affinity, similar to the insulin autoantibodies characteristic of insulin autoimmune syndrome (IAS). Production of these "IAS-like" insulin antibodies causes marked glycemic fluctuations with postprandial hyperglycemia and fasting hypoglycemia.Case presentationA 66-year-old man with a 27-year history of diabetes was admitted because of marked glycemic fluctuations. Human insulin treatment had been initiated at age 56, followed by multiple daily injections of insulin analogs 5 years later. After the initial year of insulin analog treatment, the patient began to experience frequent morning hypoglycemic attacks and day-time hyperglycemia. Marked hyperinsulinemia (4500 μU/mL) and high titers of insulin antibodies (80.4%) with high binding capacity and low affinity indicated that IAS-like insulin antibodies were causing severe glucose fluctuations. Altering insulin formulations (insulin aspart → regular human insulin→ insulin lispro) proved to be ineffective. After several therapeutic trials, cessation of exogenous insulin and addition of mitiglinide to liraglutide with voglibose finally attenuated glycemic fluctuations with increased postprandial insulin secretion. Continuous glucose monitoring revealed improvement of morning hypoglycemia and postprandial hyperglycemia with smaller mean amplitude of glycemic excursion. Therefore, compared to exogenously injected insulin, endogenously secreted insulin directly and rapidly acts on hepatocytes and suppresses postprandial glucose output.ConclusionsProper enhancement of postprandial endogenous insulin aimed at suppressing postprandial glucose output without stimulating excessive glucose uptake in the periphery is potentially useful for treating diabetes with insulin antibody-induced glycemic instability.

CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study4

No result from this study comes from a test of the peptide.

Studies that did not test the peptide alone4

In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. These results are not evidence about taking Liraglutide.

01HumanNot a test of Liraglutide aloneCase report or seriesEfficacy outcome
In a 66-year-old man with insulin antibody-induced unstable diabetes, stopping exogenous insulin and adding mitiglinide to liraglutide with voglibose attenuated glycemic fluctuations.
In plain wordsIn one 66-year-old man, stopping insulin and using mitiglinide, liraglutide and voglibose together reduced his blood sugar swings.
Peptide
Liraglutide
Outcome
DecreaseGlycemic fluctuations
Study
n = 1
Outcome group
Glycemic control · Metabolic and weight
Source sentences
Summary
After several therapeutic trials, cessation of exogenous insulin and addition of mitiglinide to liraglutide with voglibose finally attenuated glycemic fluctuations with increased postprandial insulin secretion.
1 context sentence(design, population, supporting numbers)
Summary · context
A 66-year-old man with a 27-year history of diabetes was admitted because of marked glycemic fluctuations.
In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Liraglutide.
Show in the study text Report a problemFND-3062166301
02HumanNot a test of Liraglutide aloneCase report or seriesEfficacy outcome
In a 66-year-old man with insulin antibody-induced unstable diabetes, continuous glucose monitoring showed improved morning hypoglycemia on the regimen of mitiglinide, liraglutide and voglibose.
In plain wordsIn one 66-year-old man, morning low blood sugar improved on mitiglinide, liraglutide and voglibose together.
Peptide
Liraglutide
Outcome
DecreaseMorning hypoglycemia
Study
n = 1
Outcome group
Glycemic control · Metabolic and weight
Source sentences
Summary
Continuous glucose monitoring revealed improvement of morning hypoglycemia and postprandial hyperglycemia with smaller mean amplitude of glycemic excursion.
1 context sentence(design, population, supporting numbers)
Summary · context
A 66-year-old man with a 27-year history of diabetes was admitted because of marked glycemic fluctuations.
In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Liraglutide.
Show in the study text Report a problemFND-3062166302
03HumanNot a test of Liraglutide aloneCase report or seriesEfficacy outcome
In a 66-year-old man with insulin antibody-induced unstable diabetes, continuous glucose monitoring showed improved postprandial hyperglycemia on the regimen of mitiglinide, liraglutide and voglibose.
In plain wordsIn one 66-year-old man, high blood sugar after meals improved on mitiglinide, liraglutide and voglibose together.
Peptide
Liraglutide
Outcome
DecreasePostprandial hyperglycemia
Study
n = 1
Outcome group
Glycemic control · Metabolic and weight
Source sentences
Summary
Continuous glucose monitoring revealed improvement of morning hypoglycemia and postprandial hyperglycemia with smaller mean amplitude of glycemic excursion.
1 context sentence(design, population, supporting numbers)
Summary · context
A 66-year-old man with a 27-year history of diabetes was admitted because of marked glycemic fluctuations.
In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Liraglutide.
Show in the study text Report a problemFND-3062166303
04HumanNot a test of Liraglutide aloneCase report or seriesEfficacy outcome
In a 66-year-old man with insulin antibody-induced unstable diabetes, the mean amplitude of glycemic excursion was smaller on the regimen of mitiglinide, liraglutide and voglibose.
In plain wordsIn one 66-year-old man, the size of his blood sugar swings was smaller on mitiglinide, liraglutide and voglibose together.
Peptide
Liraglutide
Outcome
DecreaseMean amplitude of glycemic excursion
Study
n = 1
Outcome group
Glycemic control · Metabolic and weight
Source sentences
Summary
Continuous glucose monitoring revealed improvement of morning hypoglycemia and postprandial hyperglycemia with smaller mean amplitude of glycemic excursion.
1 context sentence(design, population, supporting numbers)
Summary · context
A 66-year-old man with a 27-year history of diabetes was admitted because of marked glycemic fluctuations.
In this study, Liraglutide was a lab tool or a carrier, part of a mix, or the subject of a lab method. This result is not evidence about taking Liraglutide.
Show in the study text Report a problemFND-3062166304

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

Version 2Current
12 Oct 2026, 11:11 UTC
Study results updated
Version 1
9 Oct 2026, 03:05 UTC
First added · source update from Europe PMC

Subjects

Terms as the source lists them.

PepBank is a research reference. Talk to a doctor before you use any peptide.