PMC6885187_01
Clinical course defined by daily insulin requirements and initiation of oral antihyperglycemic therapy, diagnosis of latent tuberculosis, and initiation of immunomodulatory therapy. Cycle 1 of immunomodulatory therapy was initiated concomitantly with latent tuberculosis treatment.
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The peak insulin infusion rate was 2,526 units/24 hours (Figure 1). A IgM, HIV-1/2 Ag/Ab, strongyloides IgG, coccidioides IgG/IgM, and urine histoplasma antigen). After initiation of treatment for latent tuberculosis with isoniazid and pyridoxine, he underwent cycle 1 of the NIH immunomodulatory protocol with marked reduction in daily insulin requirements (Figure 1). One month following two treatment cycles, insulin therapy was discontinued and blood glucose levels were controlled on metformin and pioglitazone alone (Figure 1).