{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T03:26:41Z","timestamp":1773286001340,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2004,8,12]],"date-time":"2004-08-12T00:00:00Z","timestamp":1092268800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetic Medicine"],"published-print":{"date-parts":[[2005,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Aims\u2003<\/jats:bold> Allergy to recombinant human (rDNA) insulin preparations is a rare complication of insulin therapy. However, insulin preparations contain several allergens, and several disorders can resemble insulin allergy. Studies evaluating the diagnostic procedures on suspected insulin allergy are extremely few.<\/jats:p><jats:p><jats:bold>Methods\u2003<\/jats:bold> Since January 1998, we have used a standardized investigative procedure during admittance to the medical ward allowing observation and repeated recording of reactions to intradermal skin test (performed with a commercially available kit containing isolated insulin allergens). Data on all investigated cases until April 2003 were collected retrospectively, and self\u2010reported efficacy of intervention was compared to clinical data.<\/jats:p><jats:p><jats:bold>Results\u2003<\/jats:bold> Twenty\u2010two patients were included. In nine (41%) cases, non\u2010insulin allergic causes were discovered and successfully treated: poor injection technique (<jats:italic>n<\/jats:italic>\u00a0=\u00a05), skin disease (<jats:italic>n<\/jats:italic>\u00a0=\u00a03) and other systemic allergy (<jats:italic>n<\/jats:italic>\u00a0=\u00a01). Nine other patients were found to be allergic to protamine (<jats:italic>n<\/jats:italic>\u00a0=\u00a03) or rDNA insulin (<jats:italic>n<\/jats:italic>\u00a0=\u00a06), and specific treatment was associated with relief in 8 patients (89%). Four patients had local reactions of unknown causes but symptom relief was obtained in three cases by unspecific therapy. Overall, 20 (91%) reported relief of symptoms.<\/jats:p><jats:p><jats:bold>Conclusion\u2003<\/jats:bold> Our standardized investigative procedure of suspected insulin preparation (IP) allergy was associated with relief of symptoms in &gt; 90% of patients. IP allergy was diagnosed in 41%, and intradermal testing with isolated insulin allergens was a prerequisite in identification of culprit allergen and targeting of treatment.<\/jats:p>","DOI":"10.1111\/j.1464-5491.2004.01352.x","type":"journal-article","created":{"date-parts":[[2004,12,14]],"date-time":"2004-12-14T15:33:29Z","timestamp":1103038409000},"page":"102-106","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["A rational clinical approach to suspected insulin allergy: status after five years and 22 cases"],"prefix":"10.1111","volume":"22","author":[{"given":"U.","family":"Bodtger","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Wittrup","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2004,12,2]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.1.253-a"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.24.11.2008"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-5491.2001.00454-2.x"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1398-9995.2000.00565.x"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-6749(99)70394-5"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.1998.tb03786.x"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.36.575"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.1996.tb04641.x"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)63436-9"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/0168-8227(95)01147-1"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.18.8.1195"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1080\/00015550252948149"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0536.2001.045001047.x"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0536.2001.045001036.x"},{"key":"e_1_2_7_16_2","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1007\/BF02991108","article-title":"Insulin allergy","volume":"4","author":"Grammer L","year":"1986","journal-title":"Clin Rev Allergy"},{"key":"e_1_2_7_17_2","first-page":"497","volume-title":"Ellenberg and Rifkin's Diabetes Mellitus\u2014Theory and Practice","author":"Galloway JA","year":"1990"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.1.89"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2003.93"},{"key":"e_1_2_7_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4362.1980.tb00277.x"},{"key":"e_1_2_7_21_2","first-page":"13","article-title":"Skin tests used in type I allergy testing. Position paper","volume":"44","author":"Dreborg S","year":"1989","journal-title":"Allergy"},{"key":"e_1_2_7_22_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.10.6.789"},{"key":"e_1_2_7_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1528-252X(200001)17:1<31::AID-PDI14>3.0.CO;2-9"},{"key":"e_1_2_7_24_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.25.1.242"},{"key":"e_1_2_7_25_2","doi-asserted-by":"publisher","DOI":"10.1067\/mai.2003.37"},{"key":"e_1_2_7_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/0091-6749(82)90104-X"},{"key":"e_1_2_7_27_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.16.3.155"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1464-5491.2004.01352.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1464-5491.2004.01352.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T04:16:26Z","timestamp":1696911386000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1464-5491.2004.01352.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,12,2]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2005,1]]}},"alternative-id":["10.1111\/j.1464-5491.2004.01352.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1464-5491.2004.01352.x","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,12,2]]},"assertion":[{"value":"2004-12-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}