临床资料患者女,58岁,入院前14年,因口干、多饮在外地医院检测空腹血糖13.8mmol/L,诊断为2型糖尿病(T2DM)。先后予二甲双胍、格列本脲等降糖治疗。入院前3年,患者因血糖控制不佳,遂改为精蛋白锌重组人胰岛素混合注射液治疗,20d后,出现注射部位皮肤发红,散在多个大小不等的圆形红色皮疹,高出皮肤表面,周围无充血水肿,同时伴瘙痒不适,无心慌气短、呼吸困难。先后改用门冬胰岛素30注射液等治疗,仍有上述表现,并且在上肢以 Clinical data Female, 58 years of age, 14 years before admission, due to dry mouth, drink more in the field hospital fasting blood glucose 13.8mmol / L, diagnosed with type 2 diabetes (T2DM). Has metformin, glyburide and other hypoglycemic treatment. 3 years before admission, patients with poor blood glucose control, then changed to protamine zinc recombinant human insulin injection treatment, after 20d, the injection site of the skin redness, scattered in multiple sizes ranging from round red rash, higher than the Skin surface, no congestion around the edema, accompanied by itching, palpitation, shortness of breath, difficulty breathing. Has switched to insulin aspart 30 injection treatment, there are still the above performance, and in the upper limb to