A case of type B insulin resistance syndrome with postprandial hyperglycemia successfully treated with liraglutide

We herein report a patient with type B insulin resistance in whom liraglutide significantly improved postprandial hyperglycemia that had been highly resistant to other treatments, including insulin therapy. The patient was a 73-year-old Japanese male whose hyperglycemia had worsened rapidly after being diagnosed as diabetes. His fasting plasma glucose was 77 mg/dL, HbA1c was 8.6 %, and serum insulin level was 366 /μU/mL. As anti-insulin receptor antibody was detected, we diagnosed the patient with type B insulin resistance. CGM (Continuous Glucose Monitoring) showed that liraglutide reduced the average blood glucose level from 124 mg/dL (standard deviation [SD] 59 mg/dL) to 80 mg/dL (SD 16 mg/dL) by improving the postprandial hyperglycemia and did not increase the time in a hypoglycemic state (27 % to 23 %). The meal tolerance test showed that liraglutide significantly enhanced the reactivity of the plasma insulin responses after food intake. Liraglutide was also effective as a treatment when the patient's postprandial hyperglycemia worsened again, in parallel with increasing inhibited insulin receptor rates. Our findings in this case imply the specific effect of liraglutide in improving type B insulin resistance complicated with postprandial hyperglycemia.