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Open Access Highly Accessed Case report

Successful management of allergy to the insulin excipient metacresol in a child with type 1 diabetes: a case report

Benjamin J Wheeler12* and Barry J Taylor1

Author Affiliations

1 Department of Women’s and Children’s Health, University of Otago, Dunedin, 9054, New Zealand

2 Edgar National Centre for Diabetes and Obesity Research, University of Otago, Dunedin, 9054, New Zealand

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Journal of Medical Case Reports 2012, 6:263  doi:10.1186/1752-1947-6-263

Published: 31 August 2012

Abstract

Introduction

Insulin allergy to human insulin preparations during the treatment of diabetes is suggested to occur at rates ranging from <1.0% to 2.4%. These reactions vary from mild localized reactions, which resolve with repeated exposure, to life-threatening anaphylaxis and death. The management of persistent insulin allergy in type 1 diabetes mellitus is particularly complicated because ongoing treatment with insulin is essential.

Case presentation

We present the case of a 12-year-old Caucasian girl with localized allergy to the insulin excipient metacresol, and the subsequent desensitization therapy using continuous subcutaneous insulin infusion with simultaneous intravenous insulin infusion.

Conclusions

This is the first documented case of allergy to the metacresol component of insulin in the pediatric type 1 diabetes literature. We describe an approach to diagnosis and management of metacresol allergy in type 1 diabetes.