Battles with Insulin

I am ready to give my shot. I sit with the needle poised against my skin for at least 10 seconds. And slowly, ever-so-slowly, push the tip into my abdomen. The needle sinks like a toothpick into a warm cake.

Now comes the hard part.

I deploy the plunger, sending 6 units of beef/pork insulin through my skin and layers of tissue. And the burning begins. Burning like someone is holding a match to the site of the injection. As I pull the needle out, a dark red bubble appears and an itchy, bumpy rash forms around the bubble. It has been happening every time I give a shot for the past week, every single time.

My mother makes a note to mention the reaction I'm having to the endo that next time we go. That's nearly a month away and I'm not sure I can make it that long with burning bumpy bubbling rashes cropping up on my skin four times a day. My mother tries a number of remedies, hoping to alleviate my discomfort; calamine lotion, hydrocortisone cream, bacitracin ointment, cool tea bags (at the suggestion of my hippie Aunt Kay). Nothing works. In fact, the rashes seem to be getting worse, lasting longer and becoming more painful.

My appointment with the endo is moved up. We demonstrate the phenomenon for him. He pronounces, matter-of-factly, that I'm allergic to insulin.

"Allergic to Insulin?" My mother and I both ask the question out loud.

But I've had diabetes for two years, how can I all of a sudden be allergic to insulin? What does this mean? -- You can't take something you're allergic to -- especially when your reactions seem to be getting worse.

But I had developed an allergy to insulin; I was allergic to the medication that was keeping me alive. My doctor explained that although it was rare, insulin allergies happened now and again. He suggested we start two new bottles of insulin and document any reaction I might have. He told us to call back after two days.

Home I went for more burning and itching and bumps.

We went back to his office three days after that initial visit to meet with him and an allergist. The allergist explained that it was necessary to perform skin tests to determine what types of insulin caused a reaction and which reactions were least severe. From there, I would undergo something called "desensitizaion." Although no one took the time to explain the procedure to me, its name spoke two words in my ear... "No fun."

The skin tests were itchy and painful. My arms looked like they would have if I'd done the crawl stroke through a field of poison ivy. It was determined that I am least sensitive to the beef/pork insulin combination I'm currently taking.

The desensitization process was as unpleasant as it sounded to me that day the doctor mentioned it to me and my mom. Three days on a diabetes care unit with a micro-dose of insulin every half hour, the dose increasing in small increments with each injection. Blood draws every hour to prevent any onset of DKA or hypoglycemia that might result from the change in my regimen. I fought a little at the start; then realized these micro-doses didn't sting or itch -- and, if this worked, then maybe the burning and rashes would stop altogether. I trudged through like a brave little soldier -- feeling a bit like an overused pin-the-tail-on-the-donkey game by the end of my four day hospital stay.

But my shots were more tolerable after that. And when human insulin was mass-marketed several years later, and I endured another desensitization process, the skin irriations nearly disappeared.

Here's the thing though, over the past few months, I've been developing reactions again. Some days my pump sites have been leaving huge bumps and I can't go more than a few hours without severe itching and burning at the site of the cannula, particularly if I'm giving a larger bolus dose. Plus, I don't exactly have a "rash," but my skin is a bit bumpy and pink around the areas where infusion sites have made their home.

When I called my current endo, he said he's never heard of an allergy to Humalog or Novolog Insulin. He suggested a few things to try with the infusion sites -- a different antiseptic solution, an adhesive remover, a cream that is supposed to reduce skin irritation associated with infusion sites... But -- I know what I'm feeling. I know what an allergic skin reaction feels like. And I'm pretty sure that's what's going on here.

So -- should I see an allergist? Should I go back to my endo and ask him to have another look at my diabetes history, particularly my experience with insulin allergy? Should I see an allergist and have him talk with the endo? At this point, I'm leaning toward the third option -- I think that sometimes, a doctor needs to speak with another doctor... Anyone else have opinions? Am I being paranoid/hypocondriacal here? Has anyone experienced insulin allergy -- in particular an allergy to Humalog or Novolog?