Flying under the radar: treatment of refractory hyperglycemia
Clinicians are often presented with the scenario of what to do when one medication in a drug class has failed a therapeutic trial on a patient. We encountered a patient who developed profound resistance to glargine, aspart and regular insulin, but had a rapid and sustained response to detemir. The m...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Bioscientifica
2016-07-01
|
| Series: | Endocrinology, Diabetes & Metabolism Case Reports |
| Online Access: | https://www.edmcasereports.com/articles/endocrinology-diabetes-and-metabolism-case-reports/10.1530/EDM-16-0052 |
| id |
doaj-f5222bbf4d5149e1b10a7c4635ef8380 |
|---|---|
| record_format |
Article |
| spelling |
doaj-f5222bbf4d5149e1b10a7c4635ef83802020-11-25T00:26:50ZengBioscientificaEndocrinology, Diabetes & Metabolism Case Reports2052-05732052-05732016-07-011310.1530/EDM-16-0052Flying under the radar: treatment of refractory hyperglycemiaS M Kandel0J A Cosgriff1Yale Waterbury Internal Medicine Residency Program, Yale University School of Medicine, New Haven, Connecticut, USADepartment of Medicine, Waterbury Hospital, Waterbury, Connecticut, USAClinicians are often presented with the scenario of what to do when one medication in a drug class has failed a therapeutic trial on a patient. We encountered a patient who developed profound resistance to glargine, aspart and regular insulin, but had a rapid and sustained response to detemir. The mechanism of the increased sensitivity to detemir is unclear, but may be related to an additional carbon chain on detemir shielding it from an antibody response. This case highlights the profound impact that subtle differences in molecular structure can have on biological activity and thus patient outcomes.https://www.edmcasereports.com/articles/endocrinology-diabetes-and-metabolism-case-reports/10.1530/EDM-16-0052 |
| collection |
DOAJ |
| language |
English |
| format |
Article |
| sources |
DOAJ |
| author |
S M Kandel J A Cosgriff |
| spellingShingle |
S M Kandel J A Cosgriff Flying under the radar: treatment of refractory hyperglycemia Endocrinology, Diabetes & Metabolism Case Reports |
| author_facet |
S M Kandel J A Cosgriff |
| author_sort |
S M Kandel |
| title |
Flying under the radar: treatment of refractory hyperglycemia |
| title_short |
Flying under the radar: treatment of refractory hyperglycemia |
| title_full |
Flying under the radar: treatment of refractory hyperglycemia |
| title_fullStr |
Flying under the radar: treatment of refractory hyperglycemia |
| title_full_unstemmed |
Flying under the radar: treatment of refractory hyperglycemia |
| title_sort |
flying under the radar: treatment of refractory hyperglycemia |
| publisher |
Bioscientifica |
| series |
Endocrinology, Diabetes & Metabolism Case Reports |
| issn |
2052-0573 2052-0573 |
| publishDate |
2016-07-01 |
| description |
Clinicians are often presented with the scenario of what to do when one medication in a drug class has failed a therapeutic trial on a patient. We encountered a patient who developed profound resistance to glargine, aspart and regular insulin, but had a rapid and sustained response to detemir. The mechanism of the increased sensitivity to detemir is unclear, but may be related to an additional carbon chain on detemir shielding it from an antibody response. This case highlights the profound impact that subtle differences in molecular structure can have on biological activity and thus patient outcomes. |
| url |
https://www.edmcasereports.com/articles/endocrinology-diabetes-and-metabolism-case-reports/10.1530/EDM-16-0052 |
| work_keys_str_mv |
AT smkandel flyingundertheradartreatmentofrefractoryhyperglycemia AT jacosgriff flyingundertheradartreatmentofrefractoryhyperglycemia |
| _version_ |
1725342289228726272 |