CASE REPORT article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1656453
This article is part of the Research TopicGenetic Mechanisms in Diabetes PathogenesisView all 6 articles
Case Report:Insulin Resistance in Type 1 Diabetes Mellitus: The Role of Genetic Factors
Provisionally accepted
- 1Department of Emergency Medicine, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- 2Department of Gastroenterology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China;, hangzhou, China
- 3Department of Endocrinology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China., hangzhou, China
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We report a 52-year-old man with autoantibody-negative type 1 diabetes (T1D) who presented with severe insulin resistance (IR). Whole-exome sequencing (WES) identified a heterozygous mutation in the IGF2BP2 gene (c.248A>G, p. Lys83Thr; rs4402960), associated with T2D risk. Despite intensive insulin therapy, the patient exhibited markedly elevated insulin requirements (>1.5 U/kg/day, total 140 U/day) alongside persistent hyperglycemia. The estimated glucose disposal rate(eDGR) was 4.32 mg/kg/min,indicating significant IR.The Somogyi phenomenon was ruled out via continuous glucose monitoring (CGM), and the patient was deemed to have IR. The addition of metformin, acarbose, and dapagliflozin reduced insulin requirements and significantly improved glycemic control. This case suggests T2D–associated genetic variants may contribute to IR in T1D and underscores the potential value of genetic testing in guiding targeted oral combination therapy. Keywords: Type 1 diabetes; Insulin resistance; IGF2BP2; Whole-exome sequencing; Genetic testing
Keywords: type 1 diabetes, Insulin Resistance, IGF2BP2, Whole-exome sequencing, Genetictesting
Received: 30 Jun 2025; Accepted: 26 Aug 2025.
Copyright: © 2025 Wei, lu and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Tianyue Zhang, Department of Endocrinology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China., hangzhou, China
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