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Apparent Insulin Resistance due to Abnormal Enzymatic Insulin Degradation: A New Mechanism for Insulin Resistance
Author(s) -
McElduff A.,
Eastman C. J.,
Haynes S. P.,
Bowen K. M.
Publication year - 1980
Publication title -
australian and new zealand journal of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0004-8291
DOI - 10.1111/j.1445-5994.1980.tb03421.x
Subject(s) - insulin , insulin resistance , medicine , endocrinology , insulin degrading enzyme
Summary: Apparent insulin resistance due to abnormal enzymatic insulin degradation: A new mechanism for insulin resistance. A. McElduff, C. J. Eastman, S. P. Haynes and K. M. Bowen. Aust. N.Z. J. Med ., 1980, 10 , pp. 56–61. A 16–year‐old girl presented with severe, prolonged insulin resistance. Insulin antibodies, initially thought to be responsible for the insulin resistance, were suppressed using monocomponent insulin and immunosuppressive therapy; however insulin resistance persisted. Insulin kinetic studies suggested abnormal metabolism of a bolus injection of 125 insulin and the reappearance in the circulation of radioactive products, demonstrated by chromatography to be of different molecular weight to insulin. These products were of similar molecular weight to material obtained by incubating 125 / insulin with protease. Trasylol significantly reduced the patient's insulin requirements and normalised the disappearance of 125 / insulin from the circulation. Prolonged treatment with Trasylol resulted in a fall in insulin requirement to non “insulin resistance” levels. The insulin requirement remained static when Trasylol was ceased. We propose abnormally rapid insulin degradation to be a new mechanism of resistance to insulin therapy.