Uncommon scenario of spontaneous hypoglycemia after starting carbimazole due to insulin autoimmune syndrome, characterized by high levels of insulinemia and circulating autoantibodies to insulin without prior insulin administration , a case report with Hirata syndrome with a literature review illustrating  the way to differentiated from other type of hypoglycemia and to diagnose it and the possible way of available treatment that have been used for this condition and to compare it with our case.

Mohammed Almutairi has completed his medicine board in 2010 from King Abdul-Aziz Medical City in Saudi Arabia and Endocrine and Metabolic Bone Disease Fellowship in McMaster University in Canada. He is the medical director of security forces medical services. He has couple of  publications and he participated in many national and international meeting , he is a member of task force that developed and update Saudi diabetes guidelines.