Evidence map›Paper›PMID 41574820›Full record

ArticleJournal of diabetes investigation2026

A pitfall in diagnosing type B insulin resistance syndrome: Suspected antibody interference in a patient with insulin allergy.

Satoru Manda, Aika Miya, Akinobu Nakamura, Hiraku Kameda, Tatsuya Atsumi

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PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of diabetes investigation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Satoru MandaDepartment of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
Aika MiyaDepartment of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
Akinobu NakamuraDepartment of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.ORCID https://orcid.org/0000-0002-8192-0006
Hiraku KamedaDepartment of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.ORCID https://orcid.org/0000-0003-1870-6688
Tatsuya AtsumiDepartment of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The patient was a 73-year-old man with diabetes who developed marked hyperglycemia after several years of insulin therapy. Investigations showed marked hyperinsulinemia, positive insulin antibodies with low affinity/high binding capacity, insulin-specific IgE and eosinophil infiltration on skin biopsy, confirming insulin allergy. Positivity for insulin receptor autoantibodies (IRAb) initially led to a diagnosis of type B insulin resistance syndrome. However, a relatively low C-peptide level (1.57 ng/mL) despite severe hyperinsulinemia (1231.9 μU/mL) was key for differentiation. After cessation of insulin and initiating a multi-drug anti-diabetes regimen, the patient's glycemic control improved markedly, with a decrease in HbA

Indexed as

AutoantibodiesDiabetes Mellitus, Type 2HypersensitivityInsulinInsulin AntibodiesInsulin ResistanceAgedHumansMaleReceptor, InsulinAutoantibodiesInsulinInsulin AntibodiesReceptor, InsulinInsulin allergyInsulin antibodiesType B insulin resistance syndrome

Identifiers

PMID41574820
PMCPMC12950914

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