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.