Elevated Insulin-binding Capacity of Serum Proteins in a Case with Spontaneous Hypoglycemia and Mild Diabetes Not Treated with Insulin
YUKIMASA HIRATA and HIROSHI ISHIZU
The First Department of Internal Medicine, Tottori University School of Medicine, Yonago
This report deals with a Japanese male patient who showed severe spontaneous hypoglycemic attacks and mild diabetes. When he was 47-year-old, the first attack of unconsciousness occurred, and after that he was suffering from the same attacks for 5 years. After 3 years from the first attack mild diabetes was found. He was admitted in June, 1968, when he was 52-year-old. Although the patient had never been treated with insulin, his serum showed insulin-binding capacity over 3 years under our observation. A large amount of insulin determined as immunoreactive insulin was extracted with acid ethanol from his native serum. A binding reaction between the insulin-free gamma globulin fraction of the serum and pig 131I-insulin was more inhibited by crystalline human insulin than by crystalline beef insulin. No insuloma was found, but one-third of the pancreas was excised on August 21, 1968. In the histological examination a hyperplasia of the pancreatic islets was significant and there was no inflammatory reactions in the islets. After the operation the hypoglycemic attacks ceased, but the insulin-binding capacity of the serum and mild diabetic state were still observed in July, 1971.
Key words hypoglycemia; pancreatic islets; insulin antibody; diabetes mellitus
Tohoku J. Exp. Med., 1972, 107, 277-286