1例56岁女性糖尿病患者,入院前约3年使用人正规胰岛素,用药15min后注射部位皮下结节,伴瘙痒,1～4d可自行消失,并有夜间阵发性干咳。入院前6个月后改为人低精蛋白锌胰岛素,夜间干咳消失,但皮下结节存在。入院后实验室检查:嗜酸粒细胞计数0.62×109/L,嗜酸粒细胞百分比为0.69,血糖8.4mmol/L,免疫球蛋白E96.60U/mL,胰岛素自身抗体(IAA)阳性。入院当日出现哮喘发作,经治疗症状缓解。为选择适宜胰岛素制剂行皮肤试验,根据皮肤试验,选用人低精蛋白锌胰岛素10U/次,同时口服阿卡波糖、二甲双胍及吡格列酮。患者血糖控制良好,注射局部间断出现可消退的小硬结、偶有瘙痒,夜间干咳消失,无哮喘发作。 A 56-year-old woman with diabetes mellitus received formal insulin approximately 3 years prior to admission. Subcutaneous nodules at the site of injection 15 min after treatment were eliminated with pruritus 1 to 4 days after treatment and had paroxysmal nocturnal cough at night. Six months after admission, they changed to hypophosphatemic insulin, which disappeared at night. However, there were subcutaneous nodules. After admission, laboratory tests: eosinophil count 0.62 × 109 / L, eosinophils percentage 0.69, blood glucose 8.4mmol / L, immunoglobulin E96.60U / mL, insulin autoantibodies (IAA) positive. The onset of asthma on the day of admission was relieved by treatment. In order to choose the appropriate insulin preparation for skin test, according to the skin test, human hypophosphatemic zinc insulin 10U / time, while oral acarbose, metformin and pioglitazone. Patients with good glycemic control, injection of intermittent subsided small induration, occasional pruritus, nighttime dry cough disappeared, no asthma attacks.