The Insulin Analog Aspart: A Safe Alternative in Insulin Allergy

The introduction of human recombinant insulin has considerably lowered, but not eliminated, adverse reactions to insulin administration. Several reports indicate that human recombinant insulin can also induce IgE- and non–IgE-mediated local or systemic reactions (1,2). However, in most patients with allergy to human recombinant insulin, insulin lispro—a genetically engineered insulin analog (Humalog; Lilly, Indianapolis, IN)—is well tolerated and can be safely used (3,4,5). Although the main immunogenic insulin epitopes remain unchanged in the lispro molecule, it has been suggested that this analog has reduced immunogenicity because of its rapid dissociation in monomers (6).

Here we report the case of cutaneous hypersensitivity to human insulin, successfully treated with the human insulin analog aspart (NovoRapid; Novo Nordisk, Bagsværd, Denmark). This rapid-acting insulin analog is produced by recombinant technology that replaces the proline at position 28 on the …