Systematic approach to diagnosis and management of biphasic insulin allergy with local anti-inflammatory agents.

In this report, we present a patient with a rarely encountered form of biphasic insulin allergy refractory to a conventional desensitization procedure. We describe a systematic approach to this clinical problem with a set of insulin preparations containing antihistamine and/or corticosteroid to verify the type of hypersensitivity reaction and identify treatment options. The approach taken here may be of use for patients with similar conditions who require insulin for adequate diabetic management but who would otherwise be forced to discontinue insulin because of allergic reactions.