Summary The authors report the case of a 45 years old female patient, who, following gestational diabetes suffered from Type 2 diabetes mellitus for two decades.
Because of the secondary sulfanylurea failure bedtime insulin treatment was started. The administration of bedtime insulin should have been stopped because of allergic skin reaction.
By the aid of the Novo Insulin Allergy Kit immediate type insulin and delayed type protamine allergy was diagnosed.
With respect of the insulin allergy the insulin analogue Humalog Lilly was chosen which spends the shortest time in the subcutaneous tissue after injection. Humalog replaced the prandial insulin secretion during each main meal.
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The basal insulin secretion was augmented by bedtime sulfanylurea treatment. The basal insulin secretion was at least partly preserved, as no preprandial hyperglycemie developed.
Because of the short duration of action of Humalog, there was no need for snacks between the main meals. Az Hill, S, Sibbald, G: Complications of insulin treatment.
Orv Hetil Bolli, G: Importance of the use of the short acting insulin analogue LisPro in the management of Type 1 diabetes mellitus. Diabetologia Hungarica VI.