Kurtz A B, Harrington M G, Matthews J A, Nabarro J D
Diabetologia. 1979 Jan;16(1):65-7. doi: 10.1007/BF00423153.
A case of factitious diabetes is reported. The patient gave herself insulin intermittently over a four year period. A high concentration of insulin binding antibody was found with the antibody showing much greater avidity towards beef than human insulin. There was resistance to intravenously administered beef insulin with low concentrations of free insulin and high concentrations of bound insulin. In contrast, in response to a glucose tolerance test, both the free insulin and C-peptide responses were normal as was glucose tolerance. The clinical difference in responsiveness to the human and beef insulins is well illustrated in vitro by insulin binding differences and is probably a function not only of different equilibrium constants of the antibody for human and beef insulins but also of different high affinity binding site concentrations.
报告了一例人为性糖尿病病例。该患者在四年期间间歇性给自己注射胰岛素。发现其胰岛素结合抗体浓度很高，且该抗体对牛胰岛素的亲和力远高于人胰岛素。静脉注射牛胰岛素时存在抵抗，游离胰岛素浓度低而结合胰岛素浓度高。相比之下，葡萄糖耐量试验显示，游离胰岛素和C肽反应均正常，葡萄糖耐量也正常。体外胰岛素结合差异很好地说明了对人胰岛素和牛胰岛素反应性的临床差异，这可能不仅是抗体与人胰岛素和牛胰岛素不同平衡常数的作用，也是不同高亲和力结合位点浓度的作用。
