Insulin glargine development

She is currently doing well with a HbAlc of 6.9% on a regimen of insulin glargine at bedtime and insulin lispro at meals, and she is beginning to develop an interest in obtaining an insulin pump. She looks forward to a long and healthy life with type 1 diabetes. 

A 68-year-old man with type 2 diabetes treated with insulin and oral hypoglycemic agents developed pruritic plaques of more than 15 cm diameter at the site of his insulin injections. Skin biopsy showed an Arthus type reaction. Various insulin therapies, including insulin glargine, insulin detemir, and human insulin, produced the same response. Intra-dermal tests were positive to a variety of insulins and protamine. He was desensitized using subcutaneous human insulin and orally fexofenadine 180 mg bd and was then successfully treated with insulin glargine. The fexofenadine was stopped 6 months later. 

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