The complexities of insulin allergy: a case and approach

Table 3 Desensitization protocol by CSII with a short-acting insulin. Adapted from Yuan et al.

Day	Dose	Rate increase^a	Target rate at the end of the day
1	0.01 IU/h of dilute insulin^b	0.01 IU/h	0.24 IU/h
2	0.25 IU/h of non-dilute insulin	0.05 IU/h	1.4 IU/h
3	1.0 IU/h^c	Add 4–6 IU to the bolus insulin infusion before each meal with the insulin pump
4	Give the bolus insulin by subcutaneous injection using a syringe, with a CSII basal insulin infusion administered at the same time
4	Stop using CSII and gave the patient insulin therapy by alternative multiple subcutaneous injections

^aCheck blood glucose levels and vitals q1h
^bShort-action insulin preparation was diluted 10 times (from U100 to U10 by saline)
^cAlternatively can decrease to 0.5 IU/h at night to avoid hypoglycemia in older patients

ISSN: 1710-1492