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Allergic reactions to both Apidra and Novolog

Discussion in 'Parents of Children with Type 1' started by momof1CWDinohio, Dec 10, 2014.

  1. momof1CWDinohio

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    We just came from our quarterly endocrinologist appointment. A few weeks ago, we stopped the pump after almost 4 years on bc of allergic reactions. We have since learned he was almost definitely reacting to the Novolog.

    So we also switched to Apidra at the same time as going back to MDI. There are now red dots--pimple size-- all over his belly and legs, in all the places he's had an injection for the past few weeks. NP said allergic reaction. Makes sense bc I've noticed a very delayed onset of action with the Apidra, and it's supposed to work more quickly, I understand.

    Assuming DS is allergic to both Novolog and Apidra, these are my questions:

    1-has anyone else experienced anything like this?

    2-what preservatives are in both insulins, and is the same preservative also in Humalog?

    3-what if he is allergic to Humalog also??

    Thank you!
     
    Last edited: Dec 10, 2014
  2. jenm999

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  3. momof1CWDinohio

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  4. Joa

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    Hello,

    I think that first it should be allergological detected to what part of the insulin solution the boy is reactive.
    I know the web-site of the european medicines agency (ema) where you can find a "SUMMARY OF PRODUCT CHARACTERISTICS" of every medicine available in Europe (EU).

    Just google this document name together with with the name of the insulin. There you'll find the ingredients listet.
    (Here's a summary from the german documents in the insulinclub forum)

    If it is a reaction against one of the added ingredients (in most cases it is one of them) you can try to avoid that one with competent professional help. If it is a reaction against the insulin molecule itself it may be more diffucult.
    Than I would suggest to change over to normal insulin, that is not deviant in the structure of the molecule.

    Good luck with figuring out the bad guys in that unpleasant game.

    Regards
    Joa
     
  5. wilf

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    First of all you try Humalog. If he reacts to that then you try Regular, which is the original insulin.

    Good luck! :cwds:
     
  6. Joa

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    I would like to disadvice. If there is a reaction to the insulin molecule itself every trial of insulin hopping to an other nature deviant structure, like Humalog, may be a next risk.

    For shure, while normal insulin is by it's action the most compatible insulin for children with a high insulin sensitivity and (very) low bolus dosing (the insulin action tends to end before the food is resorbed).But it is more diffucult to handle normal insulin with growing insulin needs.

    Regards
    Joa
     
  7. Mom264

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    Just another possibility to think about. . .Are they sure it is an allergic reaction? Did the NP rule out these dots from being petechiae? Did you have bloodwork done?
    You mention tiny red marks in the places he's had injections. Do they itch? Are they hot to the touch? Or are they just red.dots?
    My dd had petechiae when she had a low platelet count. It looked just like an allergic rash on her legs, but was actually bruising from shaving her legs. When someone has a very low platelet count they bruise extremely easily.
     
  8. momof1CWDinohio

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    I guess we are not 100% sure it is an allergic reaction, but the NP and endocrinologist (based upon talking to the NP) feel it is. We have scheduled an appointment with an allergist to really try to get to the bottom of it. The red dots have not been itchy for him, but his aggravated pump sites before that were.

    It also seems that both the Apidra and Novolog stopped working well, and this supports the allergic reaction theory. (And yes, his body could have changed, but the Apidra did work well for about the first two weeks…it was just last week he started having problems.)

    I would love for this to be something else!! I hope you are right!

    Thanks for your reply.
     
    Last edited: Dec 11, 2014
  9. momof1CWDinohio

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    Thank you, Joa, for your comments. I did schedule a pediatric allergist appointment (unfortunately it's not until Jan. 29th, but they are trying to get him in earlier.) Our endocrinologist seems to feel we have many options for insulin even if there is a problem with the Humalog. That makes me feel better, but I really don't know what "normal insulin" means. Is it available as a brand? I thought there were only the three— Novolog, Humalog and Apidra.
     
  10. momof1CWDinohio

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    Thank you. He is on Humalog now (day 2). It's working so far, and we are definitely keeping our fingers crossed. I don't know about the original insulin…didn't know it was still available..?
     
  11. Joa

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    Yes, every producer of insulin is providing a "normal insulin" which is in english named "regular" or human insulin. E.g. Actrapid (by Novo Nordisk).
    I suppose that your endo is thinking of "regular" insulins if he tells you, that there are many options, because there is a big number of producers over the world and you/the endo can search them for different ingredients.

    At least it would be possible, if the situation is needing that, to mix a specific insulin solution from insulin powder (as far as I know).
    But that would be for dramatic situations, far away from the symtoms you have described.

    This litte points around old injection sites are mostly known as allergic reactions to the steel of the needle, or even more to the dry adhesive the needle is fixed with.

    Regards
    Joa
     
  12. momof1CWDinohio

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    Thank you for clarifying about the insulin. I had not known that.

    So you think my son is allergic to the needle, not the insulin. That would be so much better. But he isn't reacting to the Lantus injections (at least it doesn't appear so). And how does that explain his reactions to the pump sites before we began injections?

    I really appreciate you taking time to try to help me figure this out. Thank you.
     
  13. wilf

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    So the Lantus injections are no problem?

    And Humalog so far is good too?
     
  14. mmgirls

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    I wonder if he is allergic to the "cannula" what types of pump sites is he using?
     
  15. Joa

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    I have no idea, if the needle caps are the same. But Lantus is as far as I know acidly adjustet. Perhaps that may influence a imunological reaction?
    Pump sites are distributing a lot of adhesives ... if the reaction is depending to those?

    A delayed onset of bolus insulin with cangind to mdi may also be interrelating with a lack of basal insulin. But if Humalog is acting fine, that stands against that idea.

    So a testing of allergenes shoud perhaps include adhesives used with sites and cannulas?

    Regards
    Joa
     
  16. momof1CWDinohio

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    The Lantus injections aren't a problem at all. No site reactions, and I think we need to reduce his dose bc too many overnight lows. So it is definitely working!

    So far, the Humalog is working well. Not to be pessimistic, but we didn't see problems with Apidra for two weeks (and no problems with Novolog for almost four years). I am cautiously optimistic but still on high alert.
     
    Last edited: Dec 13, 2014
  17. momof1CWDinohio

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    That was my first thought, too. We were using the inset 30 with the Ping. We will certainly look at this when we have the allergy testing done.

    But we only administered the Apidra via injection. The reactions when using the pump were only with Novolog, because we discontinued the pump before starting Apidra.

    Also, our endocrinologist, our NP and Gary Scheiner all have told us that reactions to the cannula are extremely rare and that it is much more likely it is the insulin. I was hoping we'd be the extremely rare cannula reaction, but our Apidra experience on MDI seems to validate it is the insulin.

    I actually have several other sites to try (steel cannula and one other), but we've all been gunshy about going back to the pump. And DS has no desire at all to go back to pumping of any kind. That may change.
     
  18. momof1CWDinohio

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    Yes, I think that's what we will do. Test everything involved with pumping and MDI for allergies. Thank you!
     
  19. mamattorney

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    If he were allergic to the cannula, I wonder if there would be a reaction if you just inserted a site and didn't run any insulin through it?

    I happened to be at my allergist/asthma doctor on Tuesday for a check up and because my daughter is having problems as well, I asked him if I needed troubleshooting help for her would I go to him or a dermatologist and he said that the testing she would need a special kind of testing that he doesn't do called "Patch testing" which tests to allergies of things that come in contact with skin. He said only certain dermatologists will do that.

    That said, I don't know if there's any remediation for these allergies (like allergy shots) or if it's just a method to determine which products to avoid.
     
  20. jenm999

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    That is a super smart idea.
     

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