Fig. 20.29 
The postulated mechanism of hypoglycaemia by the AIS.
 (a) Before eating, ‘free’ insulin is in equilibrium with antibody-bound insulin and the patient is normoglycaemic. (b) During the absorptive phase, hyperglycaemia stimulates insulin secretion, and insulin is taken up by circulating antibodies. (c) In the postabsorptive phase, insulin is released from circulating antibodies and becomes available to bind with insulin receptors.