Successful Treatment of Insulin Allergy in a Type 1 Diabetic Patient by Means of Constant Subcutaneous Pump Infusion of Insulin

Sola-Gazagnes, A.; Pecquet, C.; Radermecker, Régis; Piétri, Laurence; Elgrably, F.; Slama, G; Selam, J. L.

doi:10.2337/diacare.26.10.2961

Cited by 27 publications

(17 citation statements)

References 8 publications

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“…This is not the first description of the use of CSII to treat localised insulin allergy in patients with either type 1 or type 2 diabetes, [2][3][4][5][6] and our patient's symptoms were significantly and sufficiently improved rather than cured. However, we are not aware of other examples where i-Port Advance™, a device that has been developed to make it possible for people with needle phobia to be able to inject insulin themselves, has been used for this indication.…”

Section: Discussioncontrasting

confidence: 56%

Desensitisation to subcutaneous insulin using CSII followed by i-Port Advance™

et al. 2017

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Section: Discussioncontrasting

confidence: 56%

Desensitisation to subcutaneous insulin using CSII followed by i-Port Advance™

et al. 2017

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“…However, seven weeks after the initiation of such treatment, local reactions reappeared. In a 21 year old woman, uncontrolled type 1 diabetes was observed due to severe cutaneous allergies to insulin resulting in poor compliance to intermittent insulin injections [71]. CSII using insulin lispro was initiated as a low-dose provider for both desensitisation and treatment of diabetes.…”

Section: Csii With 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

111

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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“…Therefore a treatment with an insulin pump was started in the attempt to achieve insulin tolerance by CSII, as previously reported [9]. This therapy failed as well and lipoatrophy became wider.…”

Section: Case Description and Methodsmentioning

confidence: 99%

“…This adverse effect is considered as an immunological phenomenon induced by insulin crystals [5, 6] that leads to inhibition of adipocyte differentiation probably mediated by the local hyperproduction of tumor necrosis factor-α (TNF-α; lipoblastoma-like lipoatrophy) [7, 8]. Several cases of human insulin-induced localized lipoatrophy have been previously reported that have responded to continuous subcutaneous insulin infusion system (CSII) [9]. Other patients developed this adverse effect after initiation of insulin pump treatment [10, 11].…”

Section: Introductionmentioning

confidence: 99%

Insulin Allergy and Extensive Lipoatrophy in Child with Type 1 Diabetes

et al. 2006

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Insulin allergy and lipoatrophy in type 1 diabetic patients have been previously reported but the mechanisms are not well documented. Here, we report a case emphasizing the role of abnormal local immune reaction associated with cytokine hyper production. The patient is a 7-year-old boy with a familial history of common variable immunodeficiency. Eight months after the diagnosis of type 1 diabetes, he developed signs of insulin allergy expressed as continuously extensive and profound lipoatrophy contrasting with a well-preserved metabolic control. Specific insulin allergy was confirmed by skin prick tests that showed lymphoid activated cells in the subcutaneous tissue at the site of insulin injection. All therapies reported in the literature (antihistaminic, local steroid, change to lispro insulin, immunosuppressive treatment, subcutaneous insulin pump, peritoneal insulin infusion) were not efficient. It is suggested that familial disorders of immune cell functions with abnormal and excessive cytokine production might explain these adverse effects triggered by insulin with severe allergic reactions and lipoatrophy.

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Successful Treatment of Insulin Allergy in a Type 1 Diabetic Patient by Means of Constant Subcutaneous Pump Infusion of Insulin

Cited by 27 publications

References 8 publications

Desensitisation to subcutaneous insulin using CSII followed by i-Port Advance™

Desensitisation to subcutaneous insulin using CSII followed by i-Port Advance™

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

Insulin Allergy and Extensive Lipoatrophy in Child with Type 1 Diabetes

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