Abstract
A 71-year-old man with chronic heart failure due to idiopathic dilated cardiomyopathy was diagnosed with type 2 diabetes mellitus at 63 years of age, and he started taking oral hypoglycemic agents. At 70 years of age, insulin therapy was started due to poor glycemic control. Complications of a mild itch and flare at the site of the injection arose 5 to 10 minutes after injecting insulin. He was diagnosed as having an immediate allergic reaction to insulin. The clinical physician then tried several different insulin analogues, however, the symptoms spread to his thigh and hip, and his blood glucose level remained high. He was admitted to our department a year after the initiation of insulin therapy. Considering his previous clinical course and the results of skin tests, we assumed he was allergic to insulin, zinc or protamine. We suggested continuous subcutaneous insulin infusion therapy (CSII), which would be a safer and more effective treatment for him. After he started CSII with insulin aspart, he did not show any allergic reaction and achieved better glycemic control with a decreased dose of insulin. CSII is a beneficial treatment for patients with immediate allergy to insulin preparations.
