Desensitization for one case of insulin allergic type 1 diabetes and review of literatures

Abstract

Objective To investigate the anti-allergic strategy by reporting the desensitization for one case of insulin allergic type 1 diabetes and reviewing relevant literatures. Methods Sequencing diluted insulin injection for desensitization, continuous subcutaneous insulin infusion (CSII) with Novolin R, or dexamethasone added into CSII were applied to desensitization. Observed the size of erythema and induration, the degree of itching around the site of insulin injection and measured the insulin antibody levels. Results The allergic reaction obviously alleviated during CSII, especially when the square mode of bolus was used. The slightest allergic reaction was seen during CSII with Dexamethasone, showing a small induration without erythema or itching. Three months after CSII, the erythema or itching around injection sites disappeared, except occasional small indurations at the thighs. The insulin antibody levels gradually declined to normal as well. However, a local lipoatrophy in the right abdomen turned up. Conclusions The allergic reaction is alleviated most when dexamethasone and insulin added into CSII. The square mode of bolus is helpful to alleviate the insulin allergic symptoms. Key words: Diabetes mellitus, type 1; Insulin allergy; Insulin infusion systems