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Boiled insulin is used for sorption of anti-insulin antibodies.

Before use, the vial of insulin is boiled in a water bath for 5 minutes. With a severe reaction, you can start the introduction of insulin with small doses, as described above. Such insulin will not show its hormonal action.

It will be slowly absorbed, and a depot of insulin will be created at the injection site to attract and absorb antibodies. In the future, boiled insulin is gradually replaced with regular insulin. At the same time, desensitizing therapy is carried out.

To stimulate T-cell reactions in order to suppress antibody formation, levamisole (Decaris) is used, which has a certain modulating effect on the immune system. The treatment regimen is as follows: 1st stage - desensitizing therapy with insulin in various dilutions for 3-4 days; 2nd stage - the use of levamisole in 3-day courses of 150 mg at night with an interval of 10 days.

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Adverse reactions to insulin preparations not related to the biological action of the insulin hormone. Currently, all insulin preparations are highly purified, i. practically do not contain protein impurities, and therefore the immune side reactions caused by them (allergy, insulin resistance, lipoatrophy at the injection sites) are now rare.

  • Despite the relatively high frequency of detection of autoantibodies to insulin in DM1, the frequency of immune complications of insulin therapy in DM1 and DM2 is practically the same.
  • If with predilection and daily study of inflammatory reactions at the injection site of modern insulins, then in the first 2-4 weeks of treatment they can be noted in 1-2% of cases, which spontaneously disappear in 90% of patients over the next 1-2 months, and in the rest 5% of patients - within 6-12 months.
  • There are three types of local allergic reactions and a systemic reaction to insulin preparations, and the symptoms of allergy to new insulin preparations remain the same as before in animals:
  • local immediate inflammatory with whealing: within the next 30 minutes after injection, an inflammatory reaction occurs at the injection site, which may be accompanied by pain, itching and blisters and disappears within an hour.
  • in the next few minutes after insulin administration, urticaria, angioedema, anaphylaxis and other systemic reactions develop, which, as a rule, are accompanied by an immediate local reaction.

Spent mA comprehensive analysis of allergic reactions to insulin preparations over more than 50 years of insulin therapy has shown that an immediate type of systemic allergic reaction to insulin (such as urticaria, etc.) does not occur without manifestations of allergy at the injection site (itching, redness, blistering rashes, and etc.).

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Although the differential diagnosis of an allergy to an insulin preparation from an allergy of another genesis is not difficult, since it has characteristic distinguishing features (specific symptoms).

But if doubts about the diagnosis of allergy remain, then a routine intradermal test should be performed with an insulin preparation that is considered allergenic for the patient, and insulin does not need to be diluted for this, since anaphylactic reactions do not occur even in doubtful cases. In the case of an allergy to immediate type insulin, itching, redness, blistering, sometimes with pseudopodia, etc. appear at the site of intradermal injection of insulin after about 20 minutes.

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An immediate allergy test is considered positive when a blister appears at the intradermal injection site larger than 5 mm, and a reaction is considered severe if a blister is larger than 1 cm. after 6 hours and after 24 hours.