Diabetic Ketosis Caused by the Insulin Analog Aspart–Induced Anti-Insulin Antibody: Successful Treatment With the Newest Insulin Analog Glulisine

Anti-insulin antibodies induce immunological insulin resistance and poor diabetic control in insulin-treated diabetic patients. Recently, the prevalence and levels of anti-insulin antibodies have remarkably decreased as a consequence of the purity of insulin preparations and human insulin (1). The insulin analog insulin aspart exists as hexamers that rapidly dissociate into monomers and dimmers after the subcutaneous injection; therefore, insulin aspart is supposed to be less immunogenic than human recombinant insulin (2). Here we report a type 1 diabetic patient who developed diabetic ketosis induced by severe insulin resistance caused by anti-insulin antibody after 6 years of insulin aspart use. He was treated with the newest insulin analog, insulin glulisine, which resulted …