Insulin and heparin challenge tests are useful for choosing an optimal insulin regimen in a case of subcutaneous insulin resistance

Yuko Nakamura, Mototsugu Nagao, Shunsuke Kobayashi, Takeshi Oba, Yuki Shuto, Izumi Fukuda, Shinichi Oikawa, Hitoshi Sugihara

Research output: Contribution to journalArticlepeer-review

Abstract

A 38-year-old woman with type 1 diabetes, whose fasting plasma glucose levels were >500 mg/dL under 176 U/day of subcutaneous insulin injection, was admitted to Nippon Medical School Hospital, Tokyo, Japan. When insulin was administered intravenously, she was able to maintain favorable glycemic control even under 24 U/day of regular insulin, showing that she was accompanied by subcutaneous insulin resistance. To choose an optimal insulin regimen, we carried out subcutaneous insulin challenge tests without or with heparin mixture, and found a cocktail of insulin lispro and heparin could reduce blood glucose levels markedly. As a consequence, she achieved favorable blood glucose control by continuous subcutaneous insulin infusion of the cocktail. In summary, the insulin and heparin challenge tests are useful for choosing an optimal insulin regimen in cases of subcutaneous insulin resistance.

Original languageEnglish
Pages (from-to)1370-1373
JournalJournal of Diabetes Investigation
Volume11
Issue number5
DOIs
Publication statusPublished - 2020 Sept
Externally publishedYes

Free keywords

  • Adult
  • Blood Glucose/analysis
  • Diabetes Mellitus, Type 1/drug therapy
  • Female
  • Heparin/administration & dosage
  • Humans
  • Hypoglycemic Agents/administration & dosage
  • Injections, Subcutaneous
  • Insulin Infusion Systems/standards
  • Insulin Lispro/administration & dosage
  • Insulin Resistance
  • Prognosis

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