Insulin desensitization with insulin lispro and an insulin pump in a 5-year-old child

Background and objective: Allergic reactions to insulin, though rare, can h ave serious consequences in children with type I diabetes mellitus. We repo rt a case of insulin allergy in a 5-year-old child in whom insulin desensit ization was accomplished using an insulin pump. Methods and results: A 5-year-old girl with insulin-dependent diabetes mell itus (IDDM) developed progressive reactions to insulin and was found to hav e positive intradermal skin tests to regular and NPH insulin. Addition of o ral antihistamine and co-administration of subcutaneous dexamethasone along with the insulin failed to control her symptoms. The patient was therefore hospitalized and desensitized to insulin using an insulin pump and insulin lispro. Conclusion: An insulin pump can be used for insulin desensitization in sele cted children. The slow constant infusion rate provided by the pump may be an ideal means of achieving insulin desensitization. In addition, insulin l ispro, a synthetic insulin analog, should be considered for use in insulin- allergic individuals.