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Autoimmune Hypoglycemia in Type 1 Diabetes Mellitus. BACKGROUND: Antibodies against exogenous insulin are common in type 1 diabetes mellitus patients. They can cause hypoglycemia, albeit uncommonly. CASE CHARACTERISTICS: A 14-year-old girl with type 1 diabetes mellitus presented with recurrent hypoglycemia. OUTCOME: High insulin, low C-peptide and raised insulin antibody levels documented during hypoglycemia. Plasmapheresis led to remission of hypoglycemia. MESSAGE: Antibodies to exogenous insulin should be considered as a cause of recurrent refractory hypoglycemia in type 1 diabetes mellitus patients.