Reaction at injection site

[kazisedso]

Hello Everyone hope you are all well.
Apologies for the long post

I was put on a small dose of Bolus insulin over 4 weeks ago, Apidra. I have been having postprandial highs and they have been lasting a good 4 hours before returning to normal, hence using the insulin to try and control them. I can't take oral diabetes meds, tried them all and they all upset my stomach. I currently do not take a basal insulin as my fasting readings are ok so i have been told.

I had no problems with the apidra at first, but i was only taking 3 units and that wasn't enough to rectify my readings, so as per advised i slowly increased the dose until i was getting the readings that were advised to me.

I ended up on 7 units of apidra before meals, i change my needle every single time i inject and i rotate the injection sites, unfortunately, when i increased the dose, 24 hours after injecting i was getting raised red itchy marks at the injection sites, i started to take antihistamines to see if this helped but i still kept getting the same problem. Informed my DN and she said that i was probably allergic to additives in the insulin, so she changed me to NovoRapid.

Unfortunately the same thing is happening again , i was using 4mm needles so i got some 8mm needles to inject a little deeper as i am on the heavy side, this has made no difference, i am still getting the reactions at the injection site.

DN advised that if it happened again i would have to wait until i see my consultant on the 23rd June.
What on earth are they going to do with me?, has anyone else here had the same thing happen?
Animal insulin was mentioned but only briefly so i don't know where that route would go. I can't take oral meds and it looks like i am having allergic reactions to the human bolus insulin, so whats next? i have tried the low carb route and really cannot get on with it, it leaves me very lethargic and generally feeling ill.
Any suggestions/ advice as to what could possibly happen next.

Thanks for reading
Karen

 

[leslie10152]

Hello Everyone hope you are all well.
Apologies for the long post

I was put on a small dose of Bolus insulin over 4 weeks ago, Apidra. I have been having postprandial highs and they have been lasting a good 4 hours before returning to normal, hence using the insulin to try and control them. I can't take oral diabetes meds, tried them all and they all upset my stomach. I currently do not take a basal insulin as my fasting readings are ok so i have been told.

I had no problems with the apidra at first, but i was only taking 3 units and that wasn't enough to rectify my readings, so as per advised i slowly increased the dose until i was getting the readings that were advised to me.

I ended up on 7 units of apidra before meals, i change my needle every single time i inject and i rotate the injection sites, unfortunately, when i increased the dose, 24 hours after injecting i was getting raised red itchy marks at the injection sites, i started to take antihistamines to see if this helped but i still kept getting the same problem. Informed my DN and she said that i was probably allergic to additives in the insulin, so she changed me to NovoRapid.

Unfortunately the same thing is happening again , i was using 4mm needles so i got some 8mm needles to inject a little deeper as i am on the heavy side, this has made no difference, i am still getting the reactions at the injection site.

DN advised that if it happened again i would have to wait until i see my consultant on the 23rd June.
What on earth are they going to do with me?, has anyone else here had the same thing happen?
Animal insulin was mentioned but only briefly so i don't know where that route would go. I can't take oral meds and it looks like i am having allergic reactions to the human bolus insulin, so whats next? i have tried the low carb route and really cannot get on with it, it leaves me very lethargic and generally feeling ill.
Any suggestions/ advice as to what could possibly happen next.

Thanks for reading
Karen

There appears to be a problem with the meds. I have heard of allergic reactions to insulin, both synthetic and animal derived. But I have never experienced it myself. This is definitely a job for the endocrinologist.

 

[tim2000s]

They still have Fiasp, Novorapid, Humalog, and Actrapid that they can try. There is more than one Bolus insulin....

 

[kazisedso]

Thanks for replying Leslie10152,

Yes it's looking that way , The Apidra was great apart from these red lumps.
I don't think my DN knows what to do with me as she said if it happens again with NovoRapid then its up to the consultant.

I just do not know where we go from here, i feel like they are ' chucking in the towel' so to speak, but i have also been advised that postprandial spikes cannot be ignored as they can cause problems if left untreated, but that's exactly what i am having to do, stop taking anything until i've seen the consultant.
So all my diabetic symptoms are going to return until then, and even after i have seen him i'm not hopeful anything will be resolved.

The last time i saw the consultant he was reluctant to give me anything as my HbA1c was good (49), then he read my meter readings and saw the post meal spikes and i told him they were not returning to normal levels, for at least 3-4 hours. He advised that this couldn't be left untreated and put me on Januvia ( sitagliptin) which was fine at first, then i had stomach issues with it, so got put on Repaglinide which did the same thing

So DN put me on Apidra, no stomach problems at all, just these red lumps after increasing the dose and after 3 weeks of taking it.

I am at a loss, and just wondered if anyone on here had encountered something similar.

 

[kazisedso]

Hi tim2000's,

Yes, i thought that, but was told by DN that Apidra was the go-to insulin if people are having reactions, she didn't want to give me anything at all, but spoke to another consultant and told me if i was willing to try, they would prescribe a different bolus insulin, so i said yes, and went and collected the new prescription to be told, if this happens again, then it's up to the consultant.... so i really don't know .

 

[tim2000s]

It might be the m-cresol in the insulin which you are allergic to. There is another fastish acting, insuman infusat that uses a different preservative that may work better.

 

[kazisedso]

Hi tim2000s
Is the insuman infusat used in pumps only?
Thanks

 

[gavin86]

Hi, when you say raised reddish bumps, do you mean:
- one red bump per injection (where the needle was)
- Hives (regardless of size, multiple red bumps around the site, probably itchy)
- kind of general patchy redness (not really bumpy/inflamed/itchy/sore)

The first doesn't sound like you. It happens to me sometimes, seems like a pretty normal response to a needle jab + subcutaneous injection though.

Hives are somewhat serious.. I wouldn't wait to see someone if you think it could possibly be this, unless you stop taking it - even if they're only little. It may not become a problem, but injecting something you're allergic to is probably a bad idea. At the very least you would want professional advice on continuing...

The third, I get from lantus. I've been going for 4 weeks now and it hasn't changed or caused me any trouble. I change sides of my abdomen for each injection so the effect has some time to dissipate.. I certainly keep an eye on it though.

 

[tim2000s]

Hi tim2000s
Is the insuman infusat used in pumps only?
Thanks

Any insulin can be injected. It just requires that a rational conversation is had with a consultant to get them to understand your point of view and to agree to prescribe it.

 

[kazisedso]

The image above is not my leg!! but, this is the actual colour that i get 12-24 hours after injecting.

Hi,
I have up loaded a few pics of the reaction i am getting, its not just a pin prick reaction it's quite large red area that itches, these, red areas take at least 12-24 hours to appear after the injection, they do not appear immediately.. and they do not spread all over my body, they stay where i have injected.
They do not look as red as they actually are on these pictures, but it gives you a general idea.

I have read elsewhere that this is a localised reaction and sometimes, they will stop appearing after continual use of the insulin, i.e. the body gets used to it. i am going to speak to my consultant obviously, but i am a little apprehensive as to whether i should persevere with the jabs and see if it sorts itself out, or whether if i continue i might get a more adverse reaction .

 

[noblehead]

The image above is not my leg!! but, this is the actual colour that i get 12-24 hours after injecting.

My goodness that really is nasty @kazisedso

I think the change to animal insulin is worth a try, but you could also ask to change to another brand of needles to see if this helps.

Pen needles are coated in a very fine lubricant which help with the comfort of injecting, now I don't know if all manufacturers use the same lubricant but it's worth trying a different brand just to see if it helps matters (as the red lump could be an allergic reaction to the lubricant), ask your DN/DSN if you can at least try it. Good luck.

 

[col101]

If the smaller dose was ok is it worth trying to split the dose over two sites? Realise it means more injections but might be a short term fix until you see the consultant. Good luck with it

 

[kazisedso]

Hi All,
Just an update really.....
Well, i have now tried 3 fast acting insulin's, Apidra, NovoRapid and Humulin... the latter of the 3, Humulin given to me as it seems to have less m-cresol than the others ( so my DN says after checking with the pharmacist ).
Unfortunately, every single one of these insulin's brings the same reaction at the injection site, with the Humulin causing the worst reaction and itchiness

Animal insulin has been quickly mentioned, but i have checked online and it seems like m-cresol is also present in the animal insulin available in the uk..... i have only done a quick check, so not sure how accurate this is.

I am seeing my consultant today...but to be honest, i am not holding my breath!! The last time i went to see him, he didn't even want to give me any medication as my HbA1c was good at 49.... However, after seeing my glucose readings after my meals.... ranging from 12.4 - 15.0 he said that he couldn't ignore this and tried me on sitagliptin.... long story short... it worked then caused very bad stomach problems so had to be stopped, same thing with repaglinide, hence trying the insulin route.

I would rather stay with the insulin than oral meds as it causes no problems for me apart from the nasty reaction at injection site.

Any suggestions on how i approach this with the consultant?
Thanks
Karen

 

[kazisedso]

Well... I have been to see the consultant and had the DSN in there too.
They basically do not know what to do with me, I'm having allergic reactions to all the bolus insulin they prescribe .

Referring me to a dermatologist for patch testing and want me to take glimepiride whilst I wait... here comes the stomach problems again .