Zhang P, Jiang Q, Ding B, Yan RN, Hu Y, Ma JH. Association between glucose-lowering drugs and circulating insulin antibodies induced by insulin therapy in patients with type 2 diabetes. World J Diabetes 2024; 15(7): 1489-1498 [PMID: 39099829 DOI: 10.4239/wjd.v15.i7.1489]
Corresponding Author of This Article
Jian-Hua Ma, MD, Chief Physician, Professor, Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, No. 32 Gongqinqtuan Road, Yuhua District, Nanjing 210000, Jiangsu Province, China. majianhua196503@126.com
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Jul 15, 2024; 15(7): 1489-1498 Published online Jul 15, 2024. doi: 10.4239/wjd.v15.i7.1489
Association between glucose-lowering drugs and circulating insulin antibodies induced by insulin therapy in patients with type 2 diabetes
Peng Zhang, Qing Jiang, Bo Ding, Reng-Na Yan, Yun Hu, Jian-Hua Ma
Peng Zhang, Bo Ding, Reng-Na Yan, Jian-Hua Ma, Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210000, Jiangsu Province, China
Qing Jiang, Yun Hu, Department of Endocrinology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi Medical Center, Wuxi 214000, Jiangsu Province, China
Co-first authors: Peng Zhang and Qing Jiang.
Co-corresponding authors: Yun Hu and Jian-Hua Ma.
Author contributions: Zhang P and Jiang Q are co-authors and contributed equally to this article. Jiang Q and Hu Y wrote and reviewed the manuscript; Zhang P, Ding B and Yan RN contributed to the data collection; Hu Y and Ma JH are the guarantors of this work and, as such, had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. All authors have read and agreed to the published version of the manuscript.
Supported byThe National Key R and D Program of China, No. 2018YFC1314103; and The National Natural Science Foundation of China, No. 81870563 and No. 82270838.
Institutional review board statement: The study was approved by the institutional research committee (No: KY20190926-01).
Informed consent statement: This is a retrospective study performed by review of participants’ electronic clinical records only and therefore, patient consent was not necessary and was not obtained.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Authors are happy to share the data on request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Hua Ma, MD, Chief Physician, Professor, Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, No. 32 Gongqinqtuan Road, Yuhua District, Nanjing 210000, Jiangsu Province, China. majianhua196503@126.com
Received: December 19, 2023 Revised: April 8, 2024 Accepted: May 27, 2024 Published online: July 15, 2024 Processing time: 202 Days and 2.6 Hours
Abstract
BACKGROUND
Insulin antibodies (IAs) affect blood glucose control in patients receiving insulin therapy.
AIM
To investigate the relationship between different hypoglycemic treatments and IAs in patients with type 2 diabetes mellitus (T2DM).
METHODS
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.
RESULTS
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).
CONCLUSION
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.
