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Am J Med Sci. 2017 Mar;353(3):258-262. doi: 10.1016/j.amjms.2016.07.001. Epub 2016 Aug 30.

Type B Insulin Resistance in Peru.

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Internal Medicine Program, Louis A. Weiss Memorial Hospital, Chicago, Illinois; School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru. Electronic address:
Endocrinology Unit, Hospital Nacional Dos de Mayo, Lima, Peru.
Endocrinology Unit, Hospital Nacional Arzobispo Loayza, Lima, Peru.


Type B insulin resistance (IR) is a rare autoimmune disease characterized by the presence of insulin receptor autoantibodies, resulting in a marked IR inducing hyperglycemia. Our first case is a 42-year-old female with a history of RA, SLE and Hashimoto-thyroiditis that presented with cachexia, acanthosis-nigricans, hirsutism, negative anti-insulin-ab and glucose level between 400 to 700 mg/dl, despite a total insulin dose of 1000 IU/day. She received pulses of cyclophosphamide along with prednisone. One year later the patient was off insulin and with HbA1c of 5.6%. The second case is a 42-year-old female patient that presented with polyuria, polydipsia, cachexia, acanthosis-nigricans, negative glutamic-acid-decarboxilase-ab and positive TPO-ab. She received IV infusion of regular insulin at a rate of 500 UI/d. Two years later she was off insulin with HbA1C of 5.6%. As summary, we reported a case of a disease remitted after receiving immunosuppressive therapy and a case of disease remitted spontaneously.


Developing country; Immunosuppressive therapy; Insulin resistance; Latin America; Peru

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