1. Insulin-derived Amyloidosis and Poor Glycemic Control: A Case Series
- Author
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Yoshiya Katsura, Satoshi Murakami, Yoshiki Iwaki, Yoko Nemoto, Terumasa Nagase, Masayuki Noritake, Hidenori Sekine, Keiichi Iwaya, Tsunao Oh-i, Masahiko Kure, Tomotada Odaka, Ryuji Uchida, Kazuhiro Miwa, and Fumio Kotake
- Subjects
Adult ,Blood Glucose ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Injections, Subcutaneous ,Serum insulin ,Insulin dose ,Drug Administration Schedule ,Absorption ,Japan ,Internal medicine ,medicine ,Humans ,Hypoglycemic Agents ,Insulin ,Aged ,Aged, 80 and over ,Glycated Hemoglobin ,Medicine(all) ,Dose-Response Relationship, Drug ,business.industry ,Amyloidosis ,Poor glycemic control ,Insulin absorption ,General Medicine ,Middle Aged ,medicine.disease ,Endocrinology ,Diabetes Mellitus, Type 2 ,Insulin therapy ,Female ,Hemoglobin ,Complication ,business ,Biomarkers - Abstract
Objectives Insulin-derived amyloidosis is a rare skin-related complication of insulin therapy. The purpose of this study was to show the effects of insulin-derived amyloidosis on blood glucose levels, insulin dose requirements, and insulin absorption. Methods Seven patients were found to have insulin-derived amyloidosis at the Tokyo Medical University Ibaraki Medical Center. The clinical characteristics and insulin therapy of the 7 patients were investigated. Insulin absorption was studied by comparing the serum insulin levels after insulin injections into insulin-derived amyloidosis sites versus injections into normal sites in 4 patients. Results When the insulin-derived amyloidosis was discovered, the mean hemoglobin A1c level was 9.3%, and the mean daily insulin dose was 57 units. After changing the injection sites to avoid the insulin-derived amyloidosis, the blood glucose concentrations improved, and the mean daily insulin dose could be reduced to 27 units (P = .035; 53% reduction). The insulin absorption at insulin-derived amyloidosis sites was 34% of that at normal sites (P = .030). Conclusions Insulin-derived amyloidosis caused poor glycemic control and increased insulin dose requirements because of impairments in insulin absorption.
- Published
- 2014
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