A Case of Type 2 Diabetes Mellitus Showing Immediate Cutaneous Reaction at the Injection Site of Both Human Insulin and Insulin-analog Preparations

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  • ヒトインスリンおよびインスリンアナログ製剤に即時型局所アレルギー反応を示した2型糖尿病の1例
  • 症例報告 ヒトインスリンおよびインスリンアナログ製剤に即時型局所アレルギー反応を示した2型糖尿病の1例
  • ショウレイ ホウコク ヒトインスリン オヨビ インスリンアナログ セイザイ ニ ソクジガタ キョクショ アレルギー ハンノウ オ シメシタ 2ガタ トウニョウビョウ ノ 1レイ

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Abstract

A 58-year-old man with type 2 diabetes mellitus (DM) was admitted to our hospital because of an immediate cutaneous reaction at the injection site of human insulin. The patient was diagnosed as a type 2 diabetic at 35 years of age and had received insulin treatment for three years prior to admission to our hospital because of poorly controlled DM. He complained of a mild itch and flare at the sites of injection one week after starting the therapy. The itch and flare had worsened two months before his admission. Since we suspected that his cutaneous immediate reaction might have been associated with insulin allergy against human recombinant insulin, we tried to treat him with a rapid-acting insulin analog. However, a similar cutaneous reaction occurred one week after initiating the insulin analog treatment. Skin tests using both the human insulin and insulin analog caused an itchy erythema at the injection sites, appearing after 20 minutes and lasting for 2 hours, but skin tests using the additives did not produce any cutaneous reactions, suggesting the presence of a local immediate-type allergy against both insulin and insulin analog preparations. To our knowledge, this is a rare case with local skin reactions against both human recombinant insulin and rapid-acting insulin analogs.

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