Abstract
A 25 year old male patient, who had suffered from diabetes mellitus for 5 years developed systemic allergy to insulin during lente insulin treatment. He had generalized erythema and vesicle formation and low blood pressure. After discontinuation of insulin treatment, the patient developed diabetic ketoacidosis which was treated by requent intramuscular injections of low doses of insulin. The patient was also administered steroid and antihistamine preparations for generalized insulin skin allergy. Diphenhydramine hydrochloride appeared to be effective for the insulin allergy.
Intradermal tests with commercially available insulin preparations including monocomponent semilente insulin showed strongly positive skin reactions. However, desensitization by monocomponent insulin preparation was attempted. A rapid desensitization procedure on the first day ended in failure. Subsequently, another slower desensitization schedule was begun on the second day. Allergic reactions from intradermal tests were observed on the second and third day, but no reactions were noted from subcutaneous injections. On the seventh day, the patient was given 2 units of insulin from subcutaneous injection at one time without any undesirable reactions and insulin dosage up to 20 units per day on the 22nd day.: Thereafter, he was treated by monocomponent lente insulin and was in a well-contrlled condition. The IgE level of the patient, which had been markedly elevated upon appearance of insulin allergy, was decreased toa nearly normal level by treatment with monocomponent insulin.
