{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T23:07:08Z","timestamp":1774566428066,"version":"3.50.1"},"reference-count":8,"publisher":"The Endocrine Society","issue":"3","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Type B insulin resistance syndrome (TBIRS) is rare, with an unknown prevalence, characterized by antibodies directed against the insulin receptor. TBIRS may present with hypoglycemia and\/or hyperglycemia. A case of hypoglycemia secondary to TBIRS is reported. A 24-year-old woman presented with hypoglycemia associated with the adrenergic and neuroglycopenic symptoms. Clinical examination was normal. After workup, including a 72-hour fast, glucagon test, autoimmune screen, computerized tomography of the abdomen and calcium stimulation test, no cause was apparent. The results of the 72-hour fast were equivocal. Given the lack of a diagnosis, antibodies to insulin receptors were measured and found to be positive, confirming TBIRS as the cause. Oral glucocorticoid therapy was initiated, and no further hypoglycemic episodes occurred. Steroid therapy resulted in iatrogenic Cushing syndrome. Steroid therapy was discontinued after 1 year of initiation. She delivered a healthy baby with no neonatal hypoglycemia. Hypoglycemic episodes recurred 3 years later, at which point she had relocated and was treated elsewhere. Although rare, autoimmune causes of hypoglycemia should be considered when other causes are excluded or when results are equivocal. Management with pharmacotherapy can be effective in inducing remission but long-term monitoring is necessary as patients may relapse.<\/jats:p>","DOI":"10.1210\/jcemcr\/luag008","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T12:34:34Z","timestamp":1768566874000},"source":"Crossref","is-referenced-by-count":1,"title":["Hypoglycemia secondary to type B insulin resistance syndrome"],"prefix":"10.1210","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5950-1585","authenticated-orcid":false,"given":"Poobalan","family":"Naidoo","sequence":"first","affiliation":[{"name":"Department of Diabetes and Endocrinology, Inkosi Albert Luthuli Central Hospital, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal , Kharwastan 4092 ,","place":["South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6420-3855","authenticated-orcid":false,"given":"Fraser James","family":"Pirie","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, Inkosi Albert Luthuli Central Hospital, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal , Kharwastan 4092 ,","place":["South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6720-8450","authenticated-orcid":false,"given":"Imran Mahomed","family":"Paruk","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, Inkosi Albert Luthuli Central Hospital, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal , Kharwastan 4092 ,","place":["South Africa"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"issue":"17","key":"2026022705462693800_luag008-B1","doi-asserted-by":"crossref","first-page":"335","DOI":"10.21037\/atm.2018.07.32","article-title":"Insulin autoimmune syndrome: from diagnosis to clinical management","volume":"6","author":"Censi","year":"2018","journal-title":"Ann Transl Med"},{"issue":"6","key":"2026022705462693800_luag008-B2","first-page":"87","article-title":"Syndromes of autoantibodies to the insulin receptor","volume":"13","author":"Jialal","year":"2022","journal-title":"Int J Biochem Mol Biol"},{"issue":"2","key":"2026022705462693800_luag008-B3","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1097\/00005792-200203000-00001","article-title":"Clinical course of the syndrome of autoantibodies to the insulin receptor (type B insulin resistance): a 28-year perspective","volume":"81","author":"Arioglu","year":"2002","journal-title":"Medicine (Baltimore)"},{"issue":"4","key":"2026022705462693800_luag008-B4","first-page":"337","article-title":"Type B insulin resistance syndrome: a systematic review","volume":"64","author":"Martins","year":"2020","journal-title":"Arch Endocrinol Metab"},{"key":"2026022705462693800_luag008-B5","doi-asserted-by":"crossref","first-page":"4359787","DOI":"10.1155\/2020\/4359787","article-title":"Clinical features of type B insulin resistance in Japanese patients: case report and survey-based case series study","volume":"2020","author":"Hirota","year":"2020","journal-title":"J Diabetes Res"},{"issue":"11","key":"2026022705462693800_luag008-B6","doi-asserted-by":"crossref","first-page":"2353","DOI":"10.2337\/dc18-0884","article-title":"Combined immunosuppressive therapy induces remission in patients with severe type b insulin resistance: a prospective cohort study","volume":"41","author":"Klubo-Gwiezdzinska","year":"2018","journal-title":"Diabetes Care"},{"issue":"5","key":"2026022705462693800_luag008-B7","doi-asserted-by":"crossref","first-page":"luad104","DOI":"10.1210\/jcemcr\/luad104","article-title":"Type B insulin resistance syndrome: a rare cause of hypoglycemia","volume":"1","author":"Bhat","year":"2023","journal-title":"JCEM Case Rep"},{"issue":"4","key":"2026022705462693800_luag008-B8","doi-asserted-by":"crossref","first-page":"E653","DOI":"10.1210\/jc.2010-1949","article-title":"Type B insulin resistance syndrome associated with an immune reconstitution inflammatory syndrome in an HIV-infected woman","volume":"96","author":"Mohammedi","year":"2011","journal-title":"J Clin Endocrinol Metab"}],"container-title":["JCEM Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/4\/3\/luag008\/67153833\/luag008.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/4\/3\/luag008\/67153833\/luag008.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T10:46:35Z","timestamp":1772189195000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcemcr\/article\/doi\/10.1210\/jcemcr\/luag008\/8501002"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,23]]},"references-count":8,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,2,23]]}},"URL":"https:\/\/doi.org\/10.1210\/jcemcr\/luag008","relation":{},"ISSN":["2755-1520"],"issn-type":[{"value":"2755-1520","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2026,2,23]]},"article-number":"luag008"}}