Blood insulin antibodies

ELISA is used to detect IgG autoantibodies to insulin in the blood serum. Long-term insulin therapy usually causes an increase in the amount of circulating antibodies to the administered insulin preparation in patients with type 1 diabetes mellitus. Insulin antibodies in the blood of patients are the cause of insulin resistance, the degree 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 administered insulin. 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 conduct targeted immunosuppressive treatment. However, there is not always a direct relationship between the concentration of antibodies and the degree of insulin resistance. Most often, insulin resistance occurs when insufficiently purified bovine insulin preparations containing proinsulin, glucagon, somatostatin and other impurities are administered. Highly purified insulins (mainly porcine) are used to prevent the development of insulin resistance, which do not cause the formation of antibodies. Antibodies to insulin can be detected in the blood of patients treated not only with insulin, but also with oral hypoglycemic drugs from the sulfonylurea group.

The titer of insulin antibodies may be elevated in 35-40% of patients with newly diagnosed diabetes mellitus (i.e. not treated with insulin) and in almost 100% of children within 5 years from the onset of type 1 diabetes mellitus. This is due to hyperinsulinemia occurring at the initial stage of the disease and the immune system's response. Therefore, the determination of insulin antibodies can be used to diagnose the initial stages of diabetes mellitus, its debut, latent and atypical forms (sensitivity - 40-95%, specificity - 99%). After 15 years from the onset of the disease, insulin antibodies are detected in only 20% of patients.

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