Management of insulin allergy and resistance

The pathophysiologic basis and therapy of insulin insensitivity and insulin allergy are discussed. Topics covered include primary and secondary causes of insulin insensitivity, management of insulin resistance (elimination of diabetogenic factors; use of less antigenic insulin, oral hypoglycemic agents, immunosuppression, or nonmammalian insulin), and insulin allergy and its treatment. A pharmacist's knowledge of insulin products and the pharmacologic activity of the oral hypoglycemic and immunosuppressive agents may aid in the care of patients who are allergic or resistant to insulin.