Title of project

Enhancing Clinical Diagnostics of Type B Insulin Resistance: A Collaborative, Multicentre Approach to Diagnosing a Rare Disease

Abstract

Type B insulin resistance (TBIR) is a rare and severe disorder, which can be difficult to detect in clinical practice as there is no standardised assay for measuring autoantibodies against the insulin receptor (InsR-autoAbs). This proposal outlines our plan to conduct an comprehensive systematic review of TBIR case reports, focusing on the challenges posed by circulating biomarkers. We will chart the global distribution of documented cases, summarise findings on standard laboratory markers, and catalogue both historical and emerging diagnostic tools and therapeutic approaches that have evolved over time.

The primary objective of this project is to develop a practical InsR-autoAb detection test for routine laboratory use. Our preliminary findings in the DD2 cohort revealed the presence of InsR-autoAbs in individuals with type 2 diabetes, indicating hidden autoimmune-driven insulin resistance and highlighting significant untapped potential. Nevertheless, while our existing luciferase-based immunoprecipitation method is sufficient in research settings it is not suitable for everyday clinical laboratory routines.
By collaborating with leading experts from academia and industry, we will refine this assay to create a robust, user-friendly platform which we will then rigorously validate in laboratories in the UK, Germany, the US, and Denmark. This initiative ultimately aims to address a significant gap in diabetes management by enabling improved detection, personalised treatment and continuous monitoring for patients with InsR-autoAbs.