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Particular care should be taken when a local allergic reaction is exacerbated, as this often precedes an anaphylactic reaction.

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If the manifestations of an anaphylactic reaction persist for 24-48 hours, and insulin treatment is interrupted, Coumadin is recommended: first, the patient is hospitalized, and the insulin dose is reduced by 3-4 times; and secondly, within a few days again increase the dose of insulin to therapeutic.

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If insulin therapy has been interrupted for more than 48 hours, insulin sensitivity is assessed using skin tests and Warfarin is performed. Insulin skin tests allow you to determine the drug that causes the least severe or no allergic reactions. Samples are placed with a series of 10-fold dilutions of insulin, injecting it intradermally.

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Desensitization begins with a dose that is 10 times less than the minimum, causing a positive reaction when setting skin tests. This treatment is carried out only in a hospital. First, short-acting insulin preparations are used, later, intermediate-acting insulin preparations are added to them.

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If a local allergic reaction to insulin develops during desensitization, the dose of Coumadin drug is not increased until the reaction persists. With the development of an anaphylactic reaction, the dose is halved, after which it is increased more smoothly. Sometimes, with an anaphylactic reaction, the desensitization regimen is changed, reducing the time between insulin injections.

Insulin resistance due to immune mechanisms: With a rapidly increasing need for insulin, hospitalization and examinations are necessary to rule out non-immune causes of insulin resistance and stabilize the insulin dose.

For the treatment of insulin resistance, it is sometimes enough to switch to purified porcine or human insulin, and in some cases to more concentrated (Warfarin pills) insulin solutions or to protamine-zinc-insulin. If there are sharp metabolic disturbances and the need for insulin increases significantly, prescribe prednisone, 60 mg / day orally (for children - 1-2 mg / kg / day orally).

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During treatment with corticosteroids, plasma glucose levels are constantly monitored, since hypoglycemia may develop with a rapid decrease in insulin requirements. After reducing and stabilizing the need for insulin, prednisone is prescribed every other day. Then its dose is gradually reduced, after which the drug is canceled.

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Young people and women are more predisposed to the development of allergic reactions. They rarely occur in people over 60 years of Coumadin . Allergic reactions usually develop in the first 1-4 weeks of insulin treatment, less often immediately after the start of insulin therapy. If a systemic reaction occurs (urticaria or Quincke's edema), signs of inflammation are usually observed at the injection site.