Human Insulin Analog Insulin Aspart Does Not Cause Insulin Allergy

Yasuda, Hisafumi; Nagata, Michio; Moriyama, Hiroaki; Fujihira, Kazuhiro; Kotani, Reiko; Yamada, Katsumi; Ueda, Hiroo; Yokono, Koichi

doi:10.2337/diacare.24.11.2008

Cited by 26 publications

(11 citation statements)

References 2 publications

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“…Allergic reactions during human recombinant (rDNA) insulin therapy have been reported in several cases [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. The insulin preparation (IP) contains multiple potential allergens: insulin, carrier proteins, and additives [15].…”

Section: Introductionmentioning

confidence: 99%

A rational clinical approach to suspected insulin allergy: status after five years and 22 cases

Bødtger

Wittrup

2004

Diabetic Medicine

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Section: Introductionmentioning

confidence: 99%

A rational clinical approach to suspected insulin allergy: status after five years and 22 cases

Bødtger

Wittrup

2004

Diabetic Medicine

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“…Anecdotal reports suggested local and generalized allergy to human insulin could be successfully treated with insulin lispro [45][46][47][48][49] or with insulin aspart [49][50][51]. In the series of 22 cases published by Bodtger et al [26], 5 patients were treated with insulin analogues, among whom 3 with a clear success and 2 with partial improvement.…”

Section: Insulin Analogues and Insulin Allergymentioning

confidence: 99%

Allergy reactions to insulin: effects of continuous subcutaneous insulin infusion and insulin analogues

Radermecker

Scheen

2007

Diabetes Metabolism Res

113

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SUMMARYThe purification of animal insulin preparations and the use of human recombinant insulin have markedly reduced the incidence but not completely suppressed the occurrence of insulin allergy manifestations. Advances in technologies concerning the mode of delivery of insulin, i.e. continuous subcutaneous insulin infusion (CSII), and the use of insulin analogues, resulting from the alteration in the amino acid sequence of the native insulin molecule, may influence the immunogenicity and antigenicity of native insulin. Instead of increasing allergy reactions, CSII has been reported to represent a successful alternative treatment in diabetic patients presenting local or generalized allergy to insulin or other components (zinc, protamine) of conventional treatment. Most recent reports concern CSII-treated patients using short-acting insulin analogues (essentially insulin lispro), although the precise role of these insulin analogues remains unclear as allergy to 1 them has also been described. Finally, data on antigenicity and immunogenicity of long-acting insulin analogues (glargine, detemir), which may mimic the basal insulin delivery with CSII, remain scarce at present time.

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“…Therefore, because rapid-acting insulin analogs are rapidly dissociated into monomers, they may be less likely to induce allergy. 3 This theory was supported by multiple case reports that demonstrated successful management of insulin allergy by transitioning to the rapid-acting agents insulin lispro, [25][26][27][28] insulin aspart, 29,30 or insulin glulisine. 31 Conversely, Hara et al 18 proposed that the longacting analog insulin glargine might actually be less antigenic than other analogs, and its slow dissolution could mimic a desensitization process.…”

Section: Proposed Mechanismsmentioning

confidence: 62%

“…At position B28, insulin lispro has a proline (inverted with respect to native insulin), whereas insulin aspart contains aspartic acid. 32 Yasuda et al 29 hypothesized that this modification at B28 was responsible for insulin aspart's decreased immunogenicity. Additionally, insulin glargine and insulin detemir, both long-acting analogs, also appear to have different immunologic characteristics.…”

Section: Proposed Mechanismsmentioning

confidence: 99%

Hypersensitivity Reaction to Insulin Glargine and Insulin Detemir in a Pediatric Patient: A Case Report

Badik

Chen

Letvak

et al. 2016

The Journal of Pediatric Pharmacology and Therapeutics

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Allergy to human insulin or its analogs is rare, but it is still a significant issue in current diabetes care. Allergic reactions can range from localized injection site reactions to generalized anaphylaxis, and they can be caused by excipients or the insulin molecules themselves. We presented a case of a 14-year-old male patient with generalized allergic reactions to insulin glargine and insulin detemir. The patient was successfully managed by being switched to a continuous subcutaneous insulin infusion with insulin aspart. Allergic reactions to insulin detemir and insulin glargine have both been well described, with insulin detemir allergy appearing to be more common. There are several potential mechanisms for insulin allergy, and immunologic characteristics vary among different insulin analogs. After confirming insulin allergy in practice, management involves treating symptoms and switching insulin preparations. This is the first documented case of allergies to both insulin glargine and insulin detemir in a pediatric patient. Exact mechanism of insulin allergy is unknown, and management strategies must be individualized for each patient.

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Human Insulin Analog Insulin Aspart Does Not Cause Insulin Allergy

Cited by 26 publications

References 2 publications

A rational clinical approach to suspected insulin allergy: status after five years and 22 cases

A rational clinical approach to suspected insulin allergy: status after five years and 22 cases

Allergy reactions to insulin: effects of continuous subcutaneous insulin infusion and insulin analogues

Hypersensitivity Reaction to Insulin Glargine and Insulin Detemir in a Pediatric Patient: A Case Report

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