Insulin lispro reduces insulin antibodies in a patient with type 2 diabetes with immunological insulin resistance

We describe a 54-year-old Japanese female with type 2 diabetes admitted to our hospital with poor metabolic control. On admission the patient's HbA(1c) was 9.1% despite having taken over 60 U of human insulin per day for the previous 10 years. A high titer of antibodies to insulin was detected in the serum, and therefore, we decided to introduce insulin lispro with the aim of minimizing immunogenicity. Over the next 2 months, the dosage of insulin required to achieve reasonable blood glucose control was reduced, with the HbA(1c) level decreasing significantly to 6.8%. The patient was subsequently withdrawn from insulin and discharged on diet therapy only. This case demonstrates that insulin lispro may ameliorate resistance to insulin therapy even in the presence of human insulin antibodies. (C) 2003 Elsevier Science Ireland Ltd. All rights reserved.