Hi Stacy,

In Diabetes, blood sugar levels are generally high because there's insufficient insulin to lower them. For instance, in type 1 diabetes pancreatic islet cells that produce insulin are destroyed. In type 2, the feedback mechanism becomes impaired and insulin isn't secreted the way it should be.

Hirata's, like type 1 diabetes, is an autoimmune disorder, known as autoimmune hypoglycemia. See my article on this.

Although you can have insulin antibodies, the real problem is elevated insulin levels that cause blood sugar levels to fall too low. Certain immune system genes or HLA markers are seen in this syndrome and can be used to help with diagnosis. Best, Elaine