Antiinsulin antibodies

A 35-year-old woman transferred from regular insulin to insulin lispro, as she had developed unawareness of hypoglycemia (32). After 23 months she developed a circumscribed area of lipoatrophy about 3 cm in diameter at an injection site on the right thigh. Her antiinsulin antibodies were high (50%). Six months later... 

Accurate measurement of proinsulin has been difhcult for several reasons the blood concentrations are low antibody production is difficult most antisera cross-react with insulin and C-peptide, which are present in much higher concentrations the assays measure intermediate cleavage forms of proinsulin and reference preparations of pure proinsulin are not readily available. However, a more sensitive nonequiUb-rium RIA method for measuring proinsiilin was developed by adsorbing the initial antiserum with biosynthetic human C-peptide coupled to agarose to eliminate cross-reactivity with C-peptide.An enzyme-linked immunosorbent assay (ELISA) has been described that employs an antibody to C-peptide as the coating antibody and antiinsulin antibody for detection. The detection limit is 0.25 pmol/L. ... 

Insulin allergy cannot be disassociated from resistance to insulin due to other antiinsulin antibodies. 

Combination of insulin chains on an immobilized antiinsulin antibody... 

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