Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 16, 2022; 10(20): 7163-7170
Published online Jul 16, 2022. doi: 10.12998/wjcc.v10.i20.7163
Nursing a patient with latent autoimmune diabetes in adults with insulin-related lipodystrophy, allergy, and exogenous insulin autoimmune syndrome: A case report
Fang He, Ling-Ling Xu, Yu-Xiu Li, Ya-Xiu Dong
Fang He, Ling-Ling Xu, Yu-Xiu Li, Ya-Xiu Dong, Department of Endocrinology, Peking Union Medical College Hospital, Beijing 100730, China
Author contributions: He F and Xu LL set the concept of the study; He F designed and drafted the paper, and performed analysis of the paper; Dong YX contributed to completing the survey of nurse; and Xu LL and Li YX contributed in revising the draft and approval of the final version.
Informed consent statement: The patient provided informed written consent for the publication of this case report.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ling-Ling Xu, MD, Chief Doctor, Department of Endocrinology, Peking Union Medical College Hospital, Shuaifuyuan Street, Beijing 100730, China. llxuwsh@163.com
Received: January 27, 2022
Peer-review started: January 27, 2022
First decision: March 23, 2022
Revised: March 30, 2022
Accepted: May 22, 2022
Article in press: May 22, 2022
Published online: July 16, 2022
Processing time: 158 Days and 20.4 Hours
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

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.

Keywords: Insulin allergy; Desensitization; Lipodystrophy; Exogenous insulin autoimmune syndrome; Skin test; Nursing; Case report

Core Tip: Latent autoimmune diabetes in adults (LADA) patients will have a need for exogenous insulin eventually. Once patients have developed insulin allergy, clinical treatment and nursing care become very challenging. We report a case of LADA with insulin-related lipodystrophy, allergy, and exogenous insulin autoimmune syndrome during insulin treatment. We successfully assisted the doctor to select a suitable form of insulin for timely skin testing and desensitization treatment. We describe the management of this patient from a nursing viewpoint. Here, we summarize the nursing experience of a case with complex insulin allergy requiring desensitization treatment.