Continuous Subcutaneous Insulin Infusion as an Effective Method of Desensitization Therapy for Diabetic Patients with Insulin Allergy: A 4-year Single-center Experience

Clin Ther. 2016 Nov;38(11):2489-2494.e1. doi: 10.1016/j.clinthera.2016.09.018. Epub 2016 Oct 26.

Abstract

Purpose: This article summarizes our experiences in the application of continuous subcutaneous insulin infusion (CSII) as a method of rapid desensitization therapy for diabetic patients with insulin allergy that was subsequently switched to a regimen of multiple-dose injections for long-term insulin therapy.

Methods: The clinical data of 11 diabetic patients with insulin allergy in Peking Union Medical College Hospital from April 1, 2008, through December 31, 2011, were retrospectively analyzed.

Findings: All 11 conditions were diagnosed by case history, skin testing, determination of serum specific anti-insulin IgE, and reaction to withdrawal of insulin. Seven patients accepted the traditional injection method of desensitization, and 5 patients accepted CSII with the protocol designed for this study (1 patient accepted CSII after failure by the formal method). Six of the 7 patients who accepted the traditional method and all 5 patients who accepted CSII had successful results. All 5 patients in the CSII group switched to a regimen of multiple dosage injections. In a survey of 28 nurses, both experienced nurses and practical nurses preferred to use CSII as the method of desensitization.

Implications: It is feasible and effective for diabetic patients with insulin allergy to use CSII as a method of rapid desensitization with subsequent switching to a regimen of multiple-dose injections for long-term insulin therapy.

Keywords: continuous subcutaneous insulin infusion; desensitization; diabetes mellitus; insulin allergy; multiple dosage injection.

MeSH terms

  • Adolescent
  • Aged
  • Desensitization, Immunologic / methods*
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Drug Hypersensitivity*
  • Female
  • Humans
  • Hypoglycemic Agents / administration & dosage
  • Hypoglycemic Agents / therapeutic use
  • Injections, Subcutaneous
  • Insulin / administration & dosage*
  • Insulin / therapeutic use
  • Male
  • Middle Aged
  • Retrospective Studies

Substances

  • Hypoglycemic Agents
  • Insulin