Lipoatrophy Associated With Lispro Insulin in Insulin Pump Therapy

Lipoatrophy virtually disappeared as a cutaneous complication of insulin therapy after the introduction of recombinant human insulin. Consequently, we were surprised to observe two cases of marked lipoatrophy occurring in patients treated by lispro insulin administered by continuous subcutaneous insulin infusion (CSII). The first case is a 10-year-old Caucasian girl diagnosed with type 1 diabetes at 4 years of age. HbA1c levels had ranged between 7.8 and 8.7% (normal ≤6.3%) on two daily injections of human NPH and regular insulin (Humulin-Regular; Eli Lilly, Indianapolis, IN) with ultralente (Eli Lilly) added subsequently. Apart from mild lipohypertrophy of the biceps area, there were no cutaneous complications. At 8 years of age, increased HbA1c levels and …