Autoantibodies to the insulin receptor impair clearance of plasma endogenous insulin

Hiroaki Kiyokawa*, Norio Kono, Tomoya Hamaguchi, Masanori Kawachi, Koji Tajima, Yuya Yamada, Naoko Hara, Ikuo Mineo, Masamichi Kuwajima, Seiichiro Tarui

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Plasma insulin clearnce was studied in a patient with autoantibodies to the insulin receptor, manifesting persistent hyperinsulinemia associated with alternating hyper- and hypoglycemia. In the postabsorptive period, the plasma glucose level gradually decreased. To prevent the development of hypoglycemia, glucose was infused and the glycemic level was clamped at 50 mg/dl without insulin infusion. The plasma C-peptide level was below the detectable range during the clamp, indicating no appreciable secretion of insulin. The plasma insulin level declined exponentially with a markedly prolonged disappearance rate (half-time: 3.0 h) during the study. These results indicate that hyperinsulinemia in the postabsorptive period in this patient is attributable to the impairment of plasma insulin clearance through receptor-mediated mechanisms, and also confirm that the receptor plays the principal role in plasma insulin removal.

Original languageEnglish (US)
Pages (from-to)S41-S44
JournalDiabetes Research and Clinical Practice
Volume7
Issue numberSUPPL. 1
DOIs
StatePublished - 1989

Keywords

  • Anti-insulin receptor antibody
  • Clearance
  • Glycemic clamp
  • Hyperinsulinemia

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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