Published online Jul 15, 2024. doi: 10.4239/wjd.v15.i7.1489
Revised: April 8, 2024
Accepted: May 27, 2024
Published online: July 15, 2024
Processing time: 202 Days and 2.6 Hours
Insulin antibodies (IAs) affect blood glucose control in patients receiving insulin therapy.
To investigate the relationship between different hypoglycemic treatments and IAs in patients with type 2 diabetes mellitus (T2DM).
This cross-sectional, retrospective study included 1863 patients with T2DM who were receiving exogenous insulin therapy. All patients received stable antidiabetic therapy in the last 3 months and IA levels were measured using an iodine-125 array.
A total of 1863 patients were enrolled. There were 902 (48.4%) patients who had positive IAs (IA level > 5%), with a mean IA level of 11.06% (10.39%-11.72%). IA levels were positively correlated with high fasting blood glucose (odds ratio = 1.069, P < 0.001). The proportion of positive IAs was lowest in patients using glargine only (31.9%) and highest in patients using human insulin only (70.3%), P < 0.001. The IA levels in patients using sulfonylureas/glinides (8.3%), metformin (9.6%), and dipeptidyl peptidase-4 inhibitors (8.2%) were all lower than in patients without these drugs (all P < 0.05).
Nearly half of patients on insulin therapy have positive IA antibodies, and IA antibody levels are associated with blood glucose control. Insulin glargine and a combination of oral glucose-lowering drugs were correlated with lower IA levels.
Core Tip: In this study, we found that the proportion of positive insulin antibodies (IAs) was high in type 2 diabetes patients receiving exogenous insulin therapy. Positive IAs was correlated with high fasting blood glucose, insulin glargine was associated with the lowest IA levels among the insulin regimens, and the use of insulin secretagogues, metformin, and dipeptidyl peptidase-4 inhibitors was correlated with decreased IA levels.