Clinical epidemiology of diabetes mellitus in special reference to serum insulin antibody titers, immunoreactive insulin, free insulin and total insulin levels in normal and diabetic persons
Journal
Acta Medica et Biologica
Journal Volume
28
Journal Issue
1
Pages
45
Date Issued
1980
Author(s)
Abstract
By a slight modification of the method described by Nakagawa, levels of serum immunoreactive insulin (IRI), free insulin (FI) and total insulin (TI) as well as insulin antibody titer (IAT) were investigated in 292 (70 normal and 222 diabetic) Chinese men and women. For the subjects without a history of insulin therapy, i.e., 70 normal subjects and 67 non-insulin-treated diabetics, the values of IAT ranged from 0.01-0.07 (Mean ± SD, 0.04 ± 0.01). A value of 0.07 or less was accordingly classified as normal. For 29 diabetics who started to receive insulin therapy, IAT became positive within 1-12 weeks after the insulin application. Time periods for obtaining peak IAT levels ranged from 3 weeks to 10 months. Diabetics re-treated with insulin were characterized by an early appearance of the peak IAT level. After cessation of insulin therapy in 21 diabetics, values of IAT and TI declined rapidly. Except for 3 cases, however, all showed positive IAT one year after the withdrawal of insulin. In 3 patients, IAT in their positive titers persisted for more than 2 1/2 years. Overweight subjects, both normal and non-insulin treated or insulin-treated diabetics, all showed higher FI and/or higher IRI levels than healthy subjects of normal weight. Among 105 insulin-treated diabetics, the group of persons with heavier body build required a higher daily insulin dose. Diabetics with insulin therapy of long duration or those of younger age were associated with lower IAT and TI levels. The group with extremely high IAT had the highest insulin requirement as well as the highest TI level, but showed the lowest FI level and poor diabetic control. The group with the lowest IAT, i.e., under 0.5, displayed the lowest TI level, but a conspicuously high insulin dose and poor diabetic control. Unstable diabetics were characterized by low IAT and TI values, and, contrary to expectation, poorly controlled diabetics showed relatively higher FI levels. From the above-mentioned, the following conclusions were drawn. The values of IAT and TI were significantly related to the duration of insulin treatment. The longer the duration of treatment, the lower were the values of IAT and TI. Subjects of heavier body build carried higher FI and/or higher IRI levels in most instances. An inappropriately high or low IAT level might exert an untoward influence upon diabetics. Inappropriately high insulin dose or high FI level might have adverse effects on diabetic control. IAT remained positive one year after the withdrawal of insulin treatment in over 85% of diabetics observed.
Type
journal article