Immunologic Desensitisation of Allergens and its Impact on Insulin Use in Type 1 Diabetes Mellitus: A Case Report

Abstract

Type1 diabetes mellitus, also known as juvenile diabetes is an autoimmune disorder. It is a chronic condition in which there is a destruction of pancreatic beta cells by autoimmune response. Here, a case of a 13-year-old girl, weighing 32 kg and with a Body Mass index (BMI) of 13.9 kg/m2 was reported to the family medicine clinic with complaints of weakness, increased appetite and thirst, and increased frequency of micturition for the past two months. Personal history revealed a consistent weight loss over the past six months with the problem of lice in the hair from the past two months. A family history of diabetes, hypertension, and allergies was present. General physical examination reveals no abnormality and vitals were within normal limits. Blood investigations revealed increased levels of random blood sugar levels, glycated Haemoglobin (HbA1c) and Immunoglobulin (Ig)E. Hormonal assay was within normal limits, and skin prick test result revealed strong positive reactions to some allergens. The treatment included subcutaneous insulin, regular physical exercise and immunologic desensitisation of food allergens through Sublingual Immunotherapy (SLIT). The treatment resulted in controlled blood glucose levels with a reduction in insulin dose, a decrease in HbA1c levels, increased body weight and an improved BMI.