In this article, a case study is presented of a 44-year-old woman with a rare disorder of type B insulin resistance. This autoimmune syndrome is caused by circulating antibodies directed at the insulin receptor. These antibodies impair insulin interaction with the cells, resulting in insulin resistance that can be so severe as to require thousands of units of exogenous insulin per day The unusual presentation and management of this patient presented a challenge to nursing and other healthcare disciplines. This report includes a description of the diagnosis, treatment, discharge planning, and follow-up care.