Antibodies that target externally administered insulin are frequently encountered in insulin therapy, with IgG antibodies being the most prevalent, while IgE antibodies are associated with insulin allergies. In high concentrations, IgG antibodies may hinder insulin’s effectiveness, potentially causing delays or reductions in its action. In rare cases, these antibodies can activate the insulin receptor, leading to episodes of hypoglycemia, often postprandial. The development of these antibodies is influenced by various factors, including insulin purity, molecular structure, storage conditions, patient age, HLA type, and administration method. Allergic reactions tend to be more common in patients exposed to beef or pork insulin rather than solely human or analog insulins. In individuals not previously treated with insulin, the presence of insulin auto-antibodies may indicate the onset of type 1 diabetes. These antibodies react similarly to both analog and unmodified human insulins.
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