Abstract
Introduction Controlling hyperglycaemia is essential for reducing the risk of diabetes-related complications,1 but hypoglycaemia is a recognised consequence of blood glucose-lowering therapy.2,3 Rapid lowering of blood glucose has been reported to cause dermatological manifestations, such as urticaria, in addition to autonomic and neuroglycopaenic symptoms.4 It is known that use of oral hypoglycaemic agents and insulin is associated with various side effects including skin manifestations.5–7 Local hypersensitivity reactions are well reported with insulin treatment and drug eruptions have been reported with metformin.8 To date there are no reports of worsening of urticaria related to treatment with insulin and oral hypoglycaemic agents, other than in the setting of acute hypoglycaemia. We present here a case of recurrent flare of urticaria with the introduction of several hypoglycaemic agents (oral and injectable).
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