Clinical Immunotherapeutics

, Volume 2, Issue 1, pp 7–12 | Cite as

Insulin Allergy

Epidemiology and Management
  • Ramon Lleonart Bellfill
Practical Therapeutics
First Online:

Summary

The incidence of insulin allergy has decreased but has not been eliminated with the increased use of recombinant human insulin. A search of the literature for 1985 to 1993 identified a number of articles reporting hypersensitivity reactions to human insulin. Most of the reactions were local and occurred in patients allergic to insulins of animal origin who had been changed to human insulin. Nevertheless, primary allergy, sometimes severe, to human insulin and to the insulin additives protamine and zinc have been described.

We have to be able to manage diabetic patients with such reactions. It is essential to establish an accurate diagnosis of allergy to insulin itself or to its additives. Skin cutaneous tests, in association with clinical history, have a high specificity for the diagnosis of insulin allergy. The clinical relevance of anti-insulin immunoglobulin E and total immunoglobulin antibody production to insulin is speculative.

The patient should be treated with the least allergenic insulin, but if reactions still occur, it will be necessary to carry out desensitisation or other alternatives to induce tolerance to insulin. Additional investigations are necessary to understand the immunogenetics, mechanisms and implications of antibody responses to insulin.

Keywords

Human Insulin Protamine Allergy Clin Immunol Local Reaction Acanthosis Nigricans 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Copyright information

© Adis International Limited 1994

Authors and Affiliations

  • Ramon Lleonart Bellfill
    • 1
  1. 1.Allergy Unit, Servei d’Al.lèrgia, Hospital General de ManresaManresaSpain

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