Henry Ford Hospital Medical Journal


José Goldman


Two patients with severe insulin-resistant diabetes mellitus and anti-insulin receptor autoantibodies are reported here. A marked decrease in the number of accessible insulin receptors was found in the monocytes of one patient. Otherwise, the Insulin receptors were of normal affinity compared to those of normal controls. Acanthosis nigricans was not present in one patient, and in the other patient it preceded the diagnosis of diabetes by ten years. We conclude that although acanthosis nigricans and insulin resistance are frequently associated, they probably do not bear a pathogenetic relationship to each other. Therefore, the investigation of anti-insulin receptor antibodies Is advisable in unexplained insulin-resistant diabetes even if acanthosis nigricans is absent.