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August 30, 2003

Daily Care

Question from Puxico, Missouri, USA:

I have had type 1 diabetes for 11 years, and my blood sugars run in the 500 mg/dl [27.8 mmol/L] and higher range constantly even though my doctors and I have tried everything from injections, to an insulin pump, and even two islet cell transplants. I only weigh about 122 pounds, I take over 180 units of insulin per day, and my blood sugars never come down. The doctors did discover why my diabetes is so hard to control. I have anti-insulin and anti-islet antibodies and I also have an absorption problem. I was just wondering if anyone had any advice or ideas I could try. I don't have much damage due to my diabetes yet, except neuropathy in my legs, and I know the good Lord is taking care of me. I am only 23 years old and I was just wondering if anyone out there had problems like I do. If so, I'd like any advice or ideas in helping my diabetes.

Answer:

Insulin antibodies are capable of inducing insulin resistance. However, it is very uncommon. It has been described that steroids can be given with a subsequent fall in your insulin requirements. It has also been noted that spontaneous remission of the problem is the usual scenario. Obviously, that has not happened in your case. I would only have your diabetes doctor talk to you about using a dose of steroids to decrease the amount of these antibodies.

JTL