He Fang, Xu Ling-Ling, Li Yu-Xiu, Dong Ya-Xiu
Department of Endocrinology, Peking Union Medical College Hospital, Beijing 100730, China.
World J Clin Cases. 2022 Jul 16;10(20):7163-7170. doi: 10.12998/wjcc.v10.i20.7163.
Latent autoimmune diabetes in adults (LADA) is a special type of type 1 diabetes mellitus. During the early stages, patients with LADA are treated with oral antidiabetics. However, insulin treatment is still required as islet function gradually declines. Once patients have developed insulin allergy, clinical treatment and nursing care become very challenging.
Here, we report a case of LADA with insulin-related lipodystrophy, allergy, and exogenous insulin autoimmune syndrome during insulin treatment, thus making it very difficult to effectively control glucose levels with insulin. We attempted subcutaneous injection and an insulin pump to desensitize the patient's response to insulin, and finally assisted the doctor to select the appropriate insulin treatment for the patient. We describe the management of this patient from a nursing viewpoint.
We summarize the nursing experience of a case with complex insulin allergy requiring desensitization treatment. Our approach is very practical and can be applied to similar patients needing insulin desensitization.
成人隐匿性自身免疫性糖尿病（LADA）是1型糖尿病的一种特殊类型。在疾病早期，LADA患者采用口服降糖药治疗。然而，随着胰岛功能逐渐衰退，仍需进行胰岛素治疗。一旦患者出现胰岛素过敏，临床治疗和护理工作将极具挑战性。
在此，我们报告1例LADA患者，在胰岛素治疗期间出现胰岛素相关脂肪营养不良、过敏及外源性胰岛素自身免疫综合征，致使使用胰岛素有效控制血糖水平变得极为困难。我们尝试皮下注射及胰岛素泵以使患者对胰岛素的反应脱敏，最终协助医生为患者选择合适的胰岛素治疗方案。我们从护理角度描述该患者的管理过程。
我们总结了1例需要脱敏治疗的复杂胰岛素过敏病例的护理经验。我们的方法非常实用，可应用于需要胰岛素脱敏的类似患者。
