Case report Severe autoimmune insulin resistance—a case report

The case A 73-year-old female with poorly controlled diabetes [glycosylated haemoglobin level (HbA1c) of>16.5%] was referred to our diabetes specialist clinic for review of her treatment. The diagnosis of type 2 diabetes was made 15 years ago but there was no significant family history of diabetes or any other autoimmune conditions. Although our pa-tient’s diabetes was initially well controlled with metformin and a sulphonylurea, her clinical condi-tion had deteriorated within the past 2 years to a degree that it was felt necessary to commence her on insulin therapy. She had symptoms of tiredness at presentation, though did not have any weight loss or ketonuria