Insulin Autoimmune Syndrome: Symptoms & Treatment

Instructor: Artem Cheprasov
It's unlikely that you've heard much about insulin autoimmune syndrome as it's a very rare condition. This lesson focuses on its symptoms and treatments, but also outlines the basics of this disorder as well.

Insulin & Blood Sugar

Have you ever heard of diabetes mellitus? Of course you have! What do you know about this condition? Probably one of two things at least. Either that it causes high blood sugar and/or that there might be low levels of insulin made by the person's body.

Now imagine the exact opposite scenario. A condition where a person's blood sugar levels are very low and where they have very high levels of insulin. That's what you get with something called insulin autoimmune syndrome. This lesson will go over some of the signs, symptoms, and possible treatments of this disorder.

Insulin Autoimmune Syndrome

Insulin autoimmune syndrome (IAS) is also known as Hirata's Disease (HD). It was first described in 1972 by Yukimasa Hirata, a Japanese man.

This is an autoimmune disorder. This means the immune system attacks the self, 'auto-'. But not all of you, of course. The immune system attacks the protein hormone called insulin using protein molecules called autoantibodies. Insulin is a hormone that lowers a person's blood sugar by helping the blood sugar move away from the blood and into a person's cells. Autoantibodies are protein molecules, called antibodies, which target a part of yourself (insulin in this case).

Specifically, people with IAS develop autoimmunity to endogenous insulin. In other words, to insulin made by their own body. Importantly, they develop this autoimmunity without ever being exposed to exogenous insulin. In other words, without ever getting insulin as a medication.

Why is this important? It's theoretically possible that a person's immune system might label an outside (exogenous) source of insulin as foreign and bad and then attack it as a result. From there, a cross-reaction might occur where the immune system might attack the person's own insulin by mistake. In IAS, that's not the case because the person never received exogenous insulin in the first place.

Signs & Symptoms

IAS has many different possible signs and symptoms and they include:

  • Fatigue
  • Blurry vision
  • Palpitations
  • Lightheadedness, dizziness and fainting
  • Sweating, which may be a 'cold' sweat
  • Shaking
  • Hyperinsulinemia, abnormally high levels of insulin in the blood. 'Hyper-' means abnormally high, '-insulin-' obviously refers to the hormone, and '-emia' refers to a condition of the blood.
  • Hypoglycemia, abnormally low levels of sugar in the blood. 'Hypo-' means abnormally low and '-glyc-' refers to sugar.
  • High levels of insulin autoantibodies

The last three are a must for this condition and would be diagnosed using a blood test. It's important the insulin autoantibodies are tested for. This is because hyperinsulinemia with hypoglycemia, on their own, are not diagnostic of IAS. Other conditions could cause this, such as an insulin-secreting tumor called an insulinoma.


Numerous treatments have been tried for IAS. One treatment approach utilizes specialized dietary therapy. The exact type of diet plan would need to be formulated for each person but examples include:

  • A diet with a normal amount of calories for the person, but spread out over 5 meals a day.
  • A low glycemic index diet with frequent small meals. In short, a low glycemic index diet is a diet that is low in readily digestible carbohydrates, like refined sugar, white rice, and white bread.

Other treatments that have been tried for IAS include:

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