Autoimmune

Hypoglycemia in a Patient
with Characterization of Insulin Receptor
Autoantibodies

INTRODUCTION

Autoimmune hypoglycemia is a very rare disease caused

by autoantibodies to the insulin receptor or to insulin itself [1].
Insulin antibody-mediated hypoglycemia is more common in
autoimmune hypoglycemia [2]. Type B insulin resistance syn-
drome is a rare disorder characterized by severe hyperglyce-
mia and acanthosis nigricans in which autoantibodies to the
insulin receptor are present in serum [3]. On review of the lit-
erature, there are few cases of spontaneous fasting hypoglyce-
mia reported, which is difficult to distinguish from other causes
of hypoglycemia such as insulinoma [4,5]. Insulin receptor
antibodies may cause hyperglycemia and/or hypoglycemia,
and have been studied in vitro [3,6]. However, the rarity of in-
sulin receptor antibody-mediated hypoglycemia has prevent-
ed extensive research into its mechanism.

Recently, we experienced a case of male patient with fre-

quent, severe fasting hypoglycemia and acanthosis nigricans.
He had no significant medical history and no history of auto-
immune disease. Laboratory evaluation revealed the presence
of insulin receptor antibodies in his serum. We treated him
with glucocorticoids and azathioprine. In order to evaluate the
mechanism of insulin receptor antibody-induced hypoglyce-
mia, we analyzed the behavior of antibodies in his serum.

Original Article
Diabetes Metab J 2011;35:80-85

doi: 10.4093/dmj.2011.35.1.80 pISSN 2233-6079 · eISSN 2233-6087

Predictive factors of years of potential life lost by
colorectal cancer
Introduction

Colorectal cancer (CRC) is one of the most frequently

diagnosed tumors worldwide. US data estimated 148 610 new
cases (2000–2005) (72800 men, 75810 women), giving rise to
55 170 deaths equally distributed for both sexes [1]. Compared
with the earlier 5-year period, this represents slightly
increased incidence and slightly decreased mortality [2]. From
2 397 615 total deaths reported in the USA in 2004 [3], 53772
(2.2%) were related to CRC [4]. As regards our community,
from a total of 12 799 deaths occurring in the Canary Islands in
2005, 383 (3%) were because of CRC [5].

This disease affects all age groups, including younger members

of the population, and contributes to the relatively high rate of
premature death. A widely used indicator of premature death
is the years of potential life lost (YPLL) [6], defined as the
number of years of life that a person theoretically loses on
dying prematurely. The use of this instrument to detect the
causes of premature mortality, including cancer, helps to
evaluate socio-sanitary costs of a disease and influences
corrective health policy measures [7]. The objective of this
study was to analyze YPLL because of CRC in our community as
well as the related clinical and pathological factors.

European Journal of Gastroenterology & Hepatology 2008,

20:766–772.