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Insulin and heparin challenge tests are useful for choosing an optimal insulin regimen in a case of subcutaneous insulin resistance

Nakamura, Yuko ; Nagao, Mototsugu LU ; Kobayashi, Shunsuke ; Oba, Takeshi ; Shuto, Yuki ; Fukuda, Izumi ; Oikawa, Shinichi and Sugihara, Hitoshi (2020) In Journal of Diabetes Investigation 11(5). p.1370-1373
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... (More)

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.

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author
; ; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
keywords
Adult, Blood Glucose/analysis, Diabetes Mellitus, Type 1/drug therapy, Female, Heparin/administration & dosage, Humans, Hypoglycemic Agents/administration & dosage, Injections, Subcutaneous, Insulin Infusion Systems/standards, Insulin Lispro/administration & dosage, Insulin Resistance, Prognosis
in
Journal of Diabetes Investigation
volume
11
issue
5
pages
1370 - 1373
publisher
Wiley-Blackwell
external identifiers
  • scopus:85085090678
  • pmid:32267995
ISSN
2040-1116
DOI
10.1111/jdi.13266
language
English
LU publication?
no
additional info
© 2020 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.
id
e642c374-71ef-4397-9624-ee35299fd7f1
date added to LUP
2023-01-12 01:51:45
date last changed
2024-07-26 03:19:46
@article{e642c374-71ef-4397-9624-ee35299fd7f1,
  abstract     = {{<p>A 38-year-old woman with type 1 diabetes, whose fasting plasma glucose levels were &gt;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.</p>}},
  author       = {{Nakamura, Yuko and Nagao, Mototsugu and Kobayashi, Shunsuke and Oba, Takeshi and Shuto, Yuki and Fukuda, Izumi and Oikawa, Shinichi and Sugihara, Hitoshi}},
  issn         = {{2040-1116}},
  keywords     = {{Adult; Blood Glucose/analysis; Diabetes Mellitus, Type 1/drug therapy; Female; Heparin/administration & dosage; Humans; Hypoglycemic Agents/administration & dosage; Injections, Subcutaneous; Insulin Infusion Systems/standards; Insulin Lispro/administration & dosage; Insulin Resistance; Prognosis}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{1370--1373}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Journal of Diabetes Investigation}},
  title        = {{Insulin and heparin challenge tests are useful for choosing an optimal insulin regimen in a case of subcutaneous insulin resistance}},
  url          = {{http://dx.doi.org/10.1111/jdi.13266}},
  doi          = {{10.1111/jdi.13266}},
  volume       = {{11}},
  year         = {{2020}},
}