Case Report
Volume: 3 | Issue: 2 | Published: Jan 01, 1970 | Pages: 87 - 90 | DOI: 10.24911/ejmcr/173-1553374788
Insulin Allergy Successfully Managed Using a Combination Of Multi-hexamer-forming Insulin Degludec and Vildagliptin-A case report
Authors: Asim Hassan , Bilal Jaja , Motasim Elamin , Saud Al Sifri
Article Info
Authors
Asim Hassan
Department of Diabetes and Endocrinology, Armed Forces Hospital AlHada, Taif, Saudi Arabia
Bilal Jaja
Department of Diabetes and Endocrinology, Armed Forces Hospital AlHada, Taif, Saudi Arabia
Motasim Elamin
Department of Diabetes and Endocrinology, Armed Forces Hospital AlHada, Taif, Saudi Arabia
Saud Al Sifri
Department of Diabetes and Endocrinology, Armed Forces Hospital AlHada, Taif, Saudi Arabia
Publication History
Received: March 23, 2019
Accepted: April 07, 2019
Published: January 01, 1970
Abstract
Background: With the introduction of recombinant formulations insulin allergy is rare, occurring in less than 1% of patients treated with insulin. However, it is a serious situation requiring immediate attention, both due to the hypersensitivity reaction and severe life threatening glucose disequilibrium. Case presentation: A case of a 68-year-old male known diabetic for 35 years noticed some generalized itching, accompanied with maculopapular, mixed vasculitic and bullous lesions. Humalog Mix50/50 was stopped and patient was started on different combinations but to no avail. Before insulin desensitization a trial of degludec was given. Fortunately, the patient tolerated degludec and vildagliptin, and sugars came under control. Conclusion: This combination of multi-hexamer-forming ultra-long-acting insulin plus a DPP4 inhibitor vildagliptin could be an effective combination in controlling blood sugars in patients who have severe allergy to multiple drugs including oral hypoglycemic agents and various insulin preparations.
Keywords: Insulin, allergy, Combination therapy, degludec, vildagliptin, case report, green
