Use of the continuous glucose monitoring system in the management of hypoglicemia in Insulin autoimmune syndrome (IAS).

Abstract

Backround: Insulin autoimune syndrome, also known as Hirata’s disease, is a rare cause of spontaneous hyperinsulinaemic hypoglicemia characterised by presence of autoantibodies directed against human insulin (IAA).

Case Report:  A 48-year-old Caucasian female patient with insulin autoimmune syndrome was studied in two different periods, for 7 days each, using a continuous monitoring system (CGM) under various treatment regimens, i.e diet modification and corticosteroids therapy.  

Discutions: The use of CGM in autoimmune hypoglycemia is encouraged and must be taken into consideration in order to prevent episodes of hypoglicemia. Includind of IAS and quantification of IAA in differential diagnosis in patients with hypoglicemia episodes and negative imaging results can prevent patients from going through unnecessary procedures.

Keywords: Insulin autoimune syndrome (IAS); Hirata’s disease; continuous monitoring system (CGM); insulin autoantibodies (IAA)