{"id":"c8c26b31-bda4-55be-84d1-260ffc60ad30","stable_key":"5d8e27d8-6a74-5560-827f-3f90908bbc34:ala-insulin-autoimmune-case","predicate":"temporally_associated_with","statement":"A reported patient developed hypoglycemia with high insulin autoantibodies after lipoic-acid exposure.","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"context_dependent","is_public":true,"mechanism_event_id":"db5c83a8-abc7-569b-a5c6-8c7dcb69d41a","mechanism_event_label":"Rare immune-mediated hypoglycemia is different from ordinary insulin sensitization.","subject":{"id":"ab091982-3acb-5a87-80fb-85dfe292c1e0","slug":"lipoic-acid","display_name":"Lipoic acid","entity_type_key":"small_molecule"},"object":{"id":"b6c4e78e-0de2-5229-abcc-e03e8529179f","slug":"insulin-autoimmune-hypoglycemia","display_name":"Hypoglycemia associated with insulin autoimmunity","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"db5c83a8-abc7-569b-a5c6-8c7dcb69d41a","stable_key":"5d8e27d8-6a74-5560-827f-3f90908bbc34:ala-insulin-autoimmune-case-event","event_type":"observed_intervention","label":"Rare immune-mediated hypoglycemia is different from ordinary insulin sensitization.","description":"A reported patient developed hypoglycemia with high insulin autoantibodies after lipoic-acid exposure.","status":"provisional","compartment":null,"participants":[{"entity":{"id":"c3a68043-d8eb-5c31-b134-7ca74223ce0b","slug":"insulin-autoantibodies","display_name":"Insulin-binding autoantibodies","entity_type_key":"protein_complex"},"role":"associated_finding","stoichiometry":null,"state_label":"","sequence_order":0,"notes":""},{"entity":{"id":"ab091982-3acb-5a87-80fb-85dfe292c1e0","slug":"lipoic-acid","display_name":"Lipoic acid","entity_type_key":"small_molecule"},"role":"subject","stoichiometry":null,"state_label":"","sequence_order":1,"notes":""},{"entity":{"id":"b6c4e78e-0de2-5229-abcc-e03e8529179f","slug":"insulin-autoimmune-hypoglycemia","display_name":"Hypoglycemia associated with insulin autoimmunity","entity_type_key":"cellular_process"},"role":"target","stoichiometry":null,"state_label":"","sequence_order":2,"notes":""}]},"contexts":[{"dimension":"evidence_span","value_text":"{\"source_cache\": \"artifacts/ala-research/17329919.abstract.txt\", \"locator\": \"Exact primary indexed abstract; zero-based, end-exclusive Unicode character offsets\", \"file_sha256\": \"966bd02f0d270b1b8ab0e6ae7403fdeb0360e0cc0ceca34dfa4eef3e30204411\", \"start_char\": 0, \"end_char\": 608, \"text_sha256\": \"966bd02f0d270b1b8ab0e6ae7403fdeb0360e0cc0ceca34dfa4eef3e30204411\"}","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"experimental_model","value_text":"Insulin autoimmune syndrome case report","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"exposure","value_text":"Lipoic-acid exposure preceding symptoms","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"Temporal case association; does not establish incidence, universal HLA susceptibility or a proved molecular antigen mechanism.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"nutrient_topic","value_text":"Alpha-lipoic acid research collection; topical membership is not evidence of a direct dietary effect.","comparator":null,"unit":null,"notes":"","entity":{"slug":"lipoic-acid","display_name":"Lipoic acid","entity_type_key":"small_molecule"}},{"dimension":"organism","value_text":"Human","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"plain_language","value_text":"Rare immune-mediated hypoglycemia is different from ordinary insulin sensitization.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"primary_references","value_text":"[ala-p17329919] Insulin Autoimmune Syndrome possibly caused by alpha lipoic acid. (2007). https://pubmed.ncbi.nlm.nih.gov/17329919/ DOI: 10.2169/internalmedicine.46.1893","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"tissue_or_cell_type","value_text":"55-year-old person with hypoglycemia and insulin autoantibodies","comparator":null,"unit":null,"notes":"","entity":null}],"evidence":[{"id":"d984bca4-e689-5897-9dd1-b6bc968e90e6","evidence_kind":"source_excerpt","locator":"Lines 1300-1311","start_line":1300,"end_line":1311,"excerpt":"### ala-insulin-autoimmune-case\nA reported patient developed hypoglycemia with high insulin autoantibodies after lipoic-acid exposure.\nCondition category: normal\nnutrient_topic: Alpha-lipoic acid research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: Rare immune-mediated hypoglycemia is different from ordinary insulin sensitization.\norganism: Human\ntissue_or_cell_type: 55-year-old person with hypoglycemia and insulin autoantibodies\nexperimental_model: Insulin autoimmune syndrome case report\nlimitations: Temporal case association; does not establish incidence, universal HLA susceptibility or a proved molecular antigen mechanism.\nexposure: Lipoic-acid exposure preceding symptoms\nevidence_span: {\"source_cache\": \"artifacts/ala-research/17329919.abstract.txt\", \"locator\": \"Exact primary indexed abstract; zero-based, end-exclusive Unicode character offsets\", \"file_sha256\": \"966bd02f0d270b1b8ab0e6ae7403fdeb0360e0cc0ceca34dfa4eef3e30204411\", \"start_char\": 0, \"end_char\": 608, \"text_sha256\": \"966bd02f0d270b1b8ab0e6ae7403fdeb0360e0cc0ceca34dfa4eef3e30204411\"}\n[ala-p17329919] Insulin Autoimmune Syndrome possibly caused by alpha lipoic acid. 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