Insulin-derived Amyloidosis and Poor Glycemic Control: A Case Series
2014
Abstract Objectives
Insulin-
derived
amyloidosisis a rare skin-related complication of
insulintherapy. The purpose of this study was to show the effects of
insulin-
derived
amyloidosison blood glucose levels,
insulindose requirements, and
insulinabsorption. Methods Seven patients were found to have
insulin-
derived
amyloidosisat the Tokyo Medical University Ibaraki Medical Center. The clinical characteristics and
insulintherapy of the 7 patients were investigated.
Insulinabsorption was studied by comparing the serum
insulinlevels after
insulininjections into
insulin-
derived
amyloidosissites versus injections into normal sites in 4 patients. Results When the
insulin-
derived
amyloidosiswas discovered, the mean hemoglobin A1c level was 9.3%, and the mean daily
insulindose was 57 units. After changing the injection sites to avoid the
insulin-
derived
amyloidosis, the blood glucose concentrations improved, and the mean daily
insulindose could be reduced to 27 units ( P = .035; 53% reduction). The
insulinabsorption at
insulin-
derived
amyloidosissites was 34% of that at normal sites ( P = .030). Conclusions
Insulin-
derived
amyloidosiscaused poor glycemic control and increased
insulindose requirements because of impairments in
insulinabsorption.
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