In that case, oral antihyperglycemic drug may be effective. Now a days, metformin, glibenclamide are very common antihyperglycemic oral drug. Some people use these drug to avoid insulin injection difficulties. 

As far as IgE-mediated hypersensitivity to insulin is concerned, four strategies of treatment are available: 1) sostitution of inslin with another kind of insulin formulation  tolerated by the patient investigated by skin tests and ImmunoCap for insulins; 2) keep patient desensitized through the placement of an infusion pump, 3) desensitization strategy with various protocols,  and, recently, the use of Omalizumab (anti -IgE agent )

Type 1 diabetic patient can not live without external insulin. So allergy is a huge problem. You can try to investigate whether additives, that are different in insulin preparations, are the cause of allergy. Starting with very  low doses can desensitize the patient (in that way insulin pump, dosing very little doses, can help)

Another drugs, which are not insulin are not effective (sulphonylureas, metformin), or not yet accepted to treat diabetes type 1. There are ongoing trials regarding GLP1-antagonists, but used together with  insulin.

Though there are several references in the recent scientist literature about allergy to insulin, I’d like to recommend to you four articles where you can find the answer to your question:

-Heinzerling L. Insulin allergy. Diabetic Medicine. 2013;30:891-2.

-Jacquier J, Chik CL, Senior PA. A practical, clinical approach to the assessment and management of suspected insulin allergy. Diabetic Medicine. 2013;30:977-85.

-Akinci B, Yener S, Bayraktar F, Yesil S. Allergic reactions to human insulin: a review of current knowledge and treatment options. Endocr. 2010;37:33-9.

-Hoffman AG, Schram SE, Ercan-Fang NG, Warshaw EM. Type I allergy to insulin: case report and review of localized and systemic reactions to insulin. Dermatitis. 2008;19:52-8.

besides the references provided above recently the role of MD 88 DEPENDENT autoimmunity and role of toll ;like reeptors with change in gut flora has shown that by injectinf il10 diabetic status can be improved -aLTHIUGH SIMI;AR STUDIES NEEDED IN HUMANS BUT offers promis8ng strategies to find novel answers for type 1 dm .

Type 1 diabetic patients rely on exogenous insulin for life & so oral diabetic medication alone will not work (in some cases where a patient has type 1 diabetes + insulin resistance the addition of insulin sensitizing agents may improve control but the patient still needs insulin injections). It is likely to be the solvent rather than the the insulin itself that the patient is allergic to so a trial of different insulins may help.  Also the use of an insulin pump so that the patient is only receiving small doses can also be helpful but the patient must receive the appropriate education.

Referral to a specialist to assertain what it is in the insulin solution that causes the reaction would alsdo be beneficial.

agree...changing among the different brands/types of insulin to try to determine if it's an excipient or specific to the analog may be helpful. I suspect insulin R would be closest to true human insulin so may be safest. There is pramlintide here in the US that is an amylin analog approved for Type 1 patients but I haven't seen anything on its use in patients with insulin allergy.

Melissa,

Amylin may a useful adjuvant therapy but insulin in a necessity for treating T1D. Others have already mentioned about using recombinant human version of insulin and combining it with a pump so at any given point there is no bolus dose, minimizing the local reaction to insulin.

Kulvinder has brought up an interesting point about potentially controlling the immune reaction by blocking innate immunity. However, the problem with such a global interference scheme is that they may well put the recipient at an alarming risk by a variety of detriments which innate immunity routinely deals with transparently.

but we in india usually have to do without infusion pumps and whete say if GnRH infusion required one tries to look for strategies with only gonadotropins even in severely hypogonadotropic hypogonadism patients and in severely obese pzatients where need GLP-1 analogs cant use the same because of nonavailability of either exenatide or liriglutide  and what does one do in such situations besides trying low doses of recombinant human insulin  and yes i agree pramlitidine an amylin analog may be used with insulin and will atleast reduce the dosage of insulin but even that is not available here  so how does one go about besides trying out the novel treatments like MyD 88 dependendent bases of TLR 2and 4 SIGNALING GETTING AFFECTED AND TRYING SOME PRO IOTICS  to alter the GIT flora as found in animal models as a causative agent or trying theayurvedic alternative although Treg cells and FOXP3 + CELLS STATUS HOW one will alter one cant say  but if something works one can try to work out the mechanism of action as so much work is being done regarding lack of local GIT immunity with lack of breast feeding and no miRNA 155 and no Treg cells formed in gut AND ABSENCE OF FOX3+CD4+Treg cells in such infants and them predisposed to immune disorders due to lak odf development of local immunity and predisposing them to asthmas and other allergic disorders  AND NO LACTOBACILLUS DEVELOPED IN git AND ABSENCE of MyD88 signaling is associated again with changed gut flora and the T1d DEVELOPMENT IS INDEPENDENT OF TLR2 and 4 ETC.  

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2574766/

http://www.ncbi.nlm.nih.gov/pubmed/15986236

Lack of better medications and devices always adds to the challenge in patient care.

Given the talent capital in country like India, I am surprised that they cannot produce their own small battery operated pump. The device is really quite simple and should not cost too much.

I fully concur about combining all the readily available tools of the trade, such as probiotics etc for a better control, provided there is no very minimal safety issues.

A great many potentially therapeutic paradigms that get developed in mice prove less or entirely ineffective in men. In general, just to reiterate, global tinkering with immune response seems like a bad idea to me. Some day when immunologists can selectively establish a tolerance towards specific cells (beta cells in case of T1D), that will undoubtedly be the cause for great celebration. 

well thanks tausif for your valuable comments although nobody has bothered to develop one and we struggle day in and out and agreed all murine studies dont work but as suggested by one of our fellow researchers in researchgate there is no harm in trying the ayurvedic preparation although i cn not recall his name that it works in type 1 dm although i cant know how if bet cells are getting destroyed without insulin and if patient is allergic one has to try to find out the mechanism rather than always think sceptically as a lot of treatments come outf from these herbs and it gives us a new direction in thinking. .

1º- Inmunology study ( IgE total and specific by insulin)

2.º- Sustitution of insulin with another kind of insulin formulation tolerated by the patient by skin tests

3º- Treatment with infusión pump

4º- Treatment by desensitization strategy