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Antibodies to insulin in the blood
Last reviewed: 19.11.2021
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To identify autoantibodies of IgG class to insulin in serum, ELISA is used. Long-term insulin therapy usually causes an increase in the number of circulating antibodies to the injected insulin preparation in patients with type 1 diabetes mellitus. Antibodies to insulin in the blood of patients are the cause of insulin resistance, the extent of which depends on their concentration. In most patients, a high level of antibodies to the hormone has a significant effect on the pharmacokinetics of the insulin administered. The level of antibodies to insulin detected in the blood is an important diagnostic parameter that allows the attending physician to correct insulin therapy and targeted immunosuppressive treatment. At the same time, there is not always a direct correlation between the concentration of antibodies and the degree of insulin resistance. Most often, the phenomenon of insulin resistance occurs when insufficiently purified bovine insulin preparations containing proinsulin, glucagon, somatostatin and other impurities are introduced. To prevent the development of insulin resistance, highly purified insulins (mainly porcine) are used, which do not cause the formation of antibodies. Antibodies to insulin can be found in the blood of patients treated not only with insulin, but also with oral gipoglycemic drugs from the sulfonylurea group.
The titer of antibodies to insulin can be increased in 35-40% of patients with newly diagnosed diabetes mellitus (i.e., not treated with insulin) and almost in 100% of children within 5 years from the onset of type 1 diabetes. This is due to hyperinsulinemia taking place in the initial stage of the disease, and the reaction of the immune system. Therefore, the detection of antibodies to insulin can be used to diagnose the initial stages of diabetes mellitus, its debut, erased and atypical forms (sensitivity - 40-95%, specificity - 99%). After 15 years from the onset of the disease, antibodies to insulin are detected only in 20% of patients.
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