AACE Endocrinology and Diabetes · Dec 17, 2025

Six-Year Follow-Up of Glucagon-like peptide-1 receptor agonist (GLP1-RA) Therapy in a Patient With Exogenous Insulin Antibody Syndrome: A Case Report

By Xia J, Yao D, Chu J et al.

BACKGROUND/OBJECTIVE: Exogenous insulin antibody syndrome (EIAS) primarily manifests in diabetic patients receiving exogenous insulin therapy. Despite its considerable prevalence, EIAS has not received substantial attention in the literature. Existing reports on the treatment and seroconversion of EIAS mainly focus on isolated cases, with limited availability of long-term follow-up data. CASE REPORT: A 74-year-old male from China presenting with obesity and type 2 diabetes complicated by diabetic nephropathy was initially managed with exogenous insulin therapy. However, over a 3-year period, poor blood glucose control, positive insulin antibodies, and hyperinsulinemia were observed, raising suspicion of EIAS. Consequently, insulin therapy was replaced with a regimen of metformin in conjunction with a glucagon-like peptide-1 receptor agonist (GLP-1RA). Notably, the patient experienced a weight loss of 22.4 kg, maintained stable blood glucose levels, and showed no progression of diabetic nephropathy. DISCUSSION: Timely adjustment of the treatment regimen is crucial to mitigate the advancement of diabetes complications in patients with EIAS. Overweight or obese individuals may derive therapeutic benefit from GLP-1RA. The transition from insulin therapy to GLP-1RA, coupled with the subsequent reversal of insulin antibodies to negative status after a 6-year interval, underscores the potential role of stable blood glucose control in impeding the progression of diabetes-related complications. CONCLUSION: Beyond the patient's insulin antibodies turning negative after 6 years of insulin cessation and GLP-1RA therapy, the stability in blood glucose control also likely contributed to the lack of progression in diabetes-related complications. GLP-1RA may represent an effective therapeutic strategy for overweight or obese EIAS patients.

doi.org/10.1016/j.aed.2025.12.008Open accessPubMed 42979053Interventions