Insulin Autoimmune Syndrome: from Diagnosis to Clinical Management

Overview

Journal Ann Transl Med

Publisher AME Publishing Company

Date 2018 Oct 12

PMID 30306074

Citations 55

Authors

Simona Censi

Caterina Mian

Corrado Betterle

Affiliations

Soon will be listed here.

Abstract

Autoimmune forms of hypoglycemia are a rare cause of low blood sugar levels among Caucasians, and often go misdiagnosed, exposing patients to lengthy series of pointless, potentially harmful and expensive tests. There are two types of autoimmune hypoglycemia. One is insulin autoimmune syndrome (IAS), which is characterized by hyperinsulinemic hypoglycemia, elevated insulin autoantibody (IAA) titers, no prior exposure to exogenous insulin, and no of pathological abnormalities of the pancreatic islets. This condition is also known as "Hirata's disease". The other is type B insulin resistance syndrome (TBIRS), a rare autoimmune disorder resulting in a broad array of abnormalities in glucose homeostasis-from hypoglycemia to extremely insulin-resistant hyperglycemia-caused by the presence of insulin receptor autoantibodies (IRAbs). This review focuses on these two syndromes, describing their epidemiology, possible genetic background, clinical presentation, pathophysiology, diagnosis and treatment.

Citing Articles

Insulin Autoimmune Syndrome: A Chinese Expert Consensus Statement.

Zhang H, Yuan M, Pan Q Aging Med (Milton). 2025; 8(1):e70007.

PMID: 39990629 PMC: 11845856. DOI: 10.1002/agm2.70007.

Pitfalls of Hypoglycemia: Uncommon Presentation of Hirata's Disease in a Caucasian Female.

Salimova D, Aloyan T, Haroun M Cureus. 2025; 17(1):e77671.

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Insulin autoantibodies, D-dimer and microalbuminuria: A cross-sectional, case-control study of type 2 diabetes.

Zhang L, Yu P, Yao F, Lu Z, Li X, Chen H World J Diabetes. 2025; 16(2):101501.

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Insulin autoimmune syndrome in a 3-year-old boy: the youngest to date in China and a narrow review.

Cheng M, Ding Y, Wang D, Gong C BMC Pediatr. 2025; 25(1):94.

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Insulin autoimmune syndrome without hypoglycemia: A different perspective of method interference.

Yesildal F, Kado A, Isman F North Clin Istanb. 2024; 11(6):575-578.

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