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Table 4 Rapid desensitization protocol via subcutaneous insulin Glargine. Adapted from Hasani-Ranjbar et al.

From: The complexities of insulin allergy: a case and approach

Day Dose Time between doses Recommendations
1 Administer 0.0001U, 0.001U, 0.01U, 0.1U, 1U 30-min intervals Check blood glucose levels and vitals q30 min
2 Administer 2U, 4U, 8U and 20U 30-min intervals In case of a local reaction, treat with an antihistamine and the last dose is repeated until no reaction occurs and then the dose increases are continued
If there are systemic reactions, treat with epinephrine and an antihistamine. Reduce the dose to one half
At high insulin doses, a 10% glucose solution can be given to counteract the glucose-lowering effect