Abstract
A case is presented of a patient who exhibited local and generalized urticarial reactions, presumably due to insulin, associated with increasing insulin requirements and a delayed hypoglycemic response to intravenously administered insulin. The presence of skin-sensitizing antibodies to insulin of various animal species was demonstrated. Insulin-binding (blocking?) antibody was also demonstrated. Administered labeled insulin was largely retained intravascularly, the insulin space approximating the plasma volume. The role of insulin-binding antibody in retaining insulin within the vascular space was related to the diminished physiologic response to insulin. The significance of these immune phenomena in the genesis of frequently observed cases of relative insulin resistance is discussed.
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