[Insulin Lispro as an alternative for insulin Humulin U in the treatment of an obese gestational diabetic woman with allergy to Humulin U. Case report].

It has been reported the case of 32-year-old obese gestational diabetic woman, treated with Humulin U and Humalog from 28 week of gestation. Seventeen days after initiation of insulin Humulin U the woman developed allergic type I cutaneous changes. During the few minutes following injection of Humulin U, the local wheal-flare reactions accompanied by itching has been occurred. These symptoms have been disappeared after a few hours. Insulin Humulin U was discontinued (18 j). Glycemia were monitored every 1-2 hours between 8 pm-6 am. Glycemia were in normal range between 8 pm. till 5 am. We have observed increase of glycemia to 6.34 mmol/l between 5 am.-6 am. The therapy was converted to Humalog injected at 5 30 am with glycemic control one hour later. The glycemic control was very good till next dose of Humalog before breakfast. The doses of Humalog were systematically increased at 5.30 am depend on glycemia at 6.30 with highest doses in 37 week of pregnancy (30 j with 180 j a day). The good glycemic control was maintained till delivery (38 week of pregnancy). That method of therapy was good tolerated and was not strenuous in spite of necessity of early awakening. We suggest that in obese gestational diabetics ultra-short insulin preparation, analog of short acting human insulin (Humalog), injected at 5.30 am might be considered as a therapeutic alteration for long acting insulin injected at evening. This observation may be interesting especially in situations in which long acting insulin injected at evening must be discontinued.