Category: Diabetes/Prediabetes/Hypoglycemia

CONTINUOUS SUBCUTANEOUS INFUSION AS TREATMENT FOR A CASE OF INSULIN ALLERGY IN TYPE 2 DIABETES MELLITUS

Monday, Apr 8
1:00 AM – 2:00 AM

Objective :

Hypersensitivity to both human insulin and insulin analogues is not common, and comprehensive studies are lacking. Despite the improvement in purification of human insulin and sophisticated development of insulin analogues, there is still a 0.1 to 0.3% incidence of insulin allergy.


Methods : n/a


Results : n/a


Discussion :

We have a case of a 71 year old man with type 2 diabetes for 20 years, with coronary artery disease and chronic kidney disease , uncontrolled on oral hypoglycemic agents. He was started on insulin glargine, but because of the development pruritic wheals in the injection sites, he was switched to insulin degludec. Similar immediate reactions were seen with degludec, isophane insulin and regular insulin.  Hence insulin injections were stopped altogether and he underwent densensitization with regular insulin by way of continuous subcutaneous insulin infusion. He tolerated the procedure well and was sent home on an insulin pump. His sugar control significantly improved on a combination of linagliptin , empagliflozin , and regular insulin through the insulin pump.


Conclusion :

Continuous subcutaneous insulin infusion is a good management option to address insulin allergy in a patient with type 2 diabetes.

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Karl Homer V. Nievera

Resident
Asian Hospital and Medical Center

internal medicine resident at asian hospital and medical center

Marie Yvette Amante

Consultant
Asian Hospital and Medical Center

Endocrinologist in asian hospital and medical center

Caroline Gloria

Consultant
Asian Hospital and Medical Center

allergology consultant at asian hospital and medical center

Nicole Andrick N. Callejas

Resident
Asian Hospital and Medical Center

Internal medicine resident at asian hospital and medical center