November 30, 2005
Insulin, Other
Question from Portland, Oregon, USA:
I am 42 years old and have had type 1 diabetes for 26 years. Over the last 10 years, I have suffered six to eight, what I would call “systemic allergic reactions” shortly after taking my insulin (NPH and Lispro). Within seconds of the injection, I can taste and smell the insulin. With a few minutes, I start feeling the reaction systems. The symptoms are swelling and redness on the face and neck, dizziness, increased heart rate and vomiting. I have also tested my blood sugar during these episodes and it tends to drop dramatically during or after the episode. My doctor has done some research, but has not really found anything to indicate what causes this. I did see another Ask the Diabetes Team question, that explains the exact same symptom. These episodes are very alarming and I am hoping that you will be able to provide additional information about their cause and seriousness.
Answer:
One thought came to me while reading your description of these episodes. Are you injecting your insulin into muscle where it is rapidly absorbed? In very thin people, there is very little subcutaneous space to inject into. When you inject into muscle, the blood flow is greater and allows for rapid absorption. This will allow the insulin to get into the blood very rapidly and cause a drop in blood sugars. It may also sensitize you to the preservative that is in the insulin. I would review your injection technique with your physician or diabetes care team and carefully catalogue any future symptoms. You cannot get away from taking insulin. In addition, only a limited number of reactions makes a true allergic reaction unlikely.
JTL
