Severe Insulin Resistance Syndrome with Spontaneous Remission

ABSTRACT
There are some rare but severe insulin resistance disord ers with severe target cell resistance to insulin. In this article, we describe an unusual case of severe insulin resistance syndrome with spontaneous remission periods. A 34-year-old male patient with Type 2 for 13 years was admitted to the inpatient clinic because of very high blood glucose levels. Although his diabetes mellitus insulin dose was increased to 260 U/day administered with four daily insulin injections, his blood glucose levels did not respond. In a steady state of treatment his blood glucose levels suddenly decreased to hypoglycemic levels and his insulin requirement ceased. After 14 months of follow-up in euglycemic status without insulin therapy, hyperglycemic symptoms recurred. Hyperglycemic and euglycemic episodes recurred again twice with shorter euglycemic periods. Insulin receptor antibody was detected. These findings are consistent with autoimmune severe insulin resistance syndrome type B with spontaneous remission.