A Rare Case of Type B Insulin Resistance Syndrome

This document presents a rare case of Type B Insulin Resistance Syndrome (TBIRS) in a 40-year-old female with systemic lupus erythematosus (SLE) and diabetes mellitus, characterized by severe insulin resistance and refractory hyperglycemia. Despite high doses of insulin, her condition required extensive treatment, including immunosuppressive therapy. TBIRS is caused by autoantibodies against insulin receptors, leading to decreased cellular insulin response. Approximately 100 cases have been reported, with 60% associated with SLE. The primary treatment goal is to manage hyperglycemia and eliminate autoantibodies, but hypoglycemia remains a significant mortality risk.