Case Report : Two Cases of Allergy to Insulin in Gestational Diabetes

• Published in: Endocrinology and metabolism (Seoul) Vol. 30; no. 3; pp. 403 - 408
• Main Authors: Gi Jun Kim, Shin Bum Kim, Seong Il Jo, Jin Kyeong Shin, Hee Sun Kwon, Hee Kyung Jeong, Jang Won Son, Seong Su Lee, Sung Rae Kim, Byung Kee Kim, Soon Jib Yoo
• Format: Journal Article
• Language: Korean
• Published: 대한내분비학회 30.09.2015
• Subjects: Diabetes; gestational; Hypersensitivity; immediate; Insulin allergy
• ISSN: 2093-596X; 2093-5978

Allergic reaction to insulin is uncommon since the introduction of human recombinant insulin preparations and is more rare in pregnant than non-pregnant females due to altered immune reaction during pregnancy. Herein, we report two cases of allergic re-action to insulin in gestational diabetes that were successfully managed. One case was a 33-year-old female using isophane-neu-tral protamine Hagedorn human insulin and insulin lispro. She experienced dyspnea, cough, urticaria and itching sensation at the sites of insulin injection immediately after insulin administration. We discontinued insulin therapy and started oral hypoglycemic agents with metformin and glibenclamide. The other case was a 32-year-old female using insulin lispro and insulin detemer. She experienced pruritus and burning sensation and multiple nodules at the sites of insulin injection. We changed the insulin from in-sulin lispro to insulin aspart. Assessments including immunoglobulin E (IgE), IgG, eosinophil, insulin antibody level and skin bi-opsy were performed. In the two cases, the symptoms were resolved after changing the insulin to oral agents or other insulin preparations. We report two cases of allergic reaction to human insulin in gestational diabetes due to its rarity.