Insulin lispro, an alternative in insulin hypersensitivity

Lluch-Bernal, M; Fernández, María Beatriz Carenas; Herrera-Pombo, J L; Sastre, Joaquı́n

doi:10.1034/j.1398-9995.1999.00988.x

Cited by 17 publications

(10 citation statements)

References 5 publications

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“…Rapid-acting insulin analogues revealed with an immediate dissociation of hexamer structure to monomers, so that they might be less antigenic [38,39]. Successful treatment of local and systemic insulin allergy has been reported with switching of insulin treatment to a rapidacting insulin analogue, namely insulin lispro [40][41][42][43], aspart [44,45] or glulisine [46]. In a series of 22 patients with insulin allergy, Bodtger et al [12] reported five patients treated with insulin analogues, of those three had full and two had partial remission.…”

Section: The Use Of Insulin Analoguesmentioning

confidence: 98%

Allergic reactions to human insulin: a review of current knowledge and treatment options

Akıncı

Yener

Bayraktar

et al. 2009

Endocr

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Section: The Use Of Insulin Analoguesmentioning

confidence: 98%

Allergic reactions to human insulin: a review of current knowledge and treatment options

Akıncı

Yener

Bayraktar

et al. 2009

Endocr

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“…Especially in patients that show allergic reactions to components of the preparation a switch to a preparation which does not contain the specific agent can lead to a cessation of symptoms (16). To offer alternatives to the patient allergic to insulin analogues, lispro, aspart and glargine with the exchange of two (B28‐proline and B29‐lysine), one (B28‐aspartate) or the exchange of one (A21‐glycine) and addition of two amino acids (B31‐arginine and B32‐arginine), respectively, have been used (17–20). Although these represent options for patients with allergy to insulin (21) they have also been known to provoke hypersensitivity reactions including type 1 allergies in clinical practice (22–25).…”

Section: Managementmentioning

confidence: 99%

Insulin allergy: clinical manifestations and management strategies

Heinzerling

Raile

Rochlitz

et al. 2008

Allergy

138

141

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Insulin allergy in patients with diabetes mellitus on insulin treatment is a rare condition. It is suspected upon noticing immediate symptoms following insulin injections. The immediate vital implications for the patient call for prompt diagnosis and management of insulin allergy. We review current knowledge and procedures based on four diabetic patients who presented in our clinic. Insulin allergy was suspected as they showed immediate symptoms after insulin injection (urticaria, rash, angioedema, hypotension, dyspnea). A detailed allergologic work‐up was performed and adequate therapy was initiated. In three of the four patients, a specific immunotherapy was started whereas in one patient a switch to oral antidiabetics was possible and consequently initiated. By standard prick testing and measurement of specific IgE antibodies, a type 1 IgE‐mediated allergy was confirmed. After initiation of insulin immunotherapy, the symptoms completely resolved in two out three of patients and significantly improved in the third patient. The fourth patient was successfully switched to oral antidiabetics. Insulin allergy is a rare but severe condition that calls for immediate allergological work‐up. It can be managed well in close cooperation between the diabetologist and the allergologist. Specific immunotherapy is efficient and should be considered.

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“…Anecdotal reports suggested local and generalized allergy to human insulin could be successfully treated with insulin lispro [45][46][47][48][49] or with insulin aspart [49][50][51]. In the series of 22 cases published by Bodtger et al [26], 5 patients were treated with insulin analogues, among whom 3 with a clear success and 2 with partial improvement.…”

Section: Insulin Analogues and Insulin Allergymentioning

confidence: 99%

Allergy reactions to insulin: effects of continuous subcutaneous insulin infusion and insulin analogues

Radermecker

Scheen

2007

Diabetes Metabolism Res

112

113

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SUMMARYThe purification of animal insulin preparations and the use of human recombinant insulin have markedly reduced the incidence but not completely suppressed the occurrence of insulin allergy manifestations. Advances in technologies concerning the mode of delivery of insulin, i.e. continuous subcutaneous insulin infusion (CSII), and the use of insulin analogues, resulting from the alteration in the amino acid sequence of the native insulin molecule, may influence the immunogenicity and antigenicity of native insulin. Instead of increasing allergy reactions, CSII has been reported to represent a successful alternative treatment in diabetic patients presenting local or generalized allergy to insulin or other components (zinc, protamine) of conventional treatment. Most recent reports concern CSII-treated patients using short-acting insulin analogues (essentially insulin lispro), although the precise role of these insulin analogues remains unclear as allergy to 1 them has also been described. Finally, data on antigenicity and immunogenicity of long-acting insulin analogues (glargine, detemir), which may mimic the basal insulin delivery with CSII, remain scarce at present time.

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Insulin lispro, an alternative in insulin hypersensitivity

Abstract: References 1. Dhaliwal A, Fink J. Vaginal itching as a manifestation of seasonal allergic disease.

Cited by 17 publications

References 5 publications

Allergic reactions to human insulin: a review of current knowledge and treatment options

Allergic reactions to human insulin: a review of current knowledge and treatment options

Insulin allergy: clinical manifestations and management strategies

Allergy reactions to insulin: effects of continuous subcutaneous insulin infusion and insulin analogues

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