Endocrine Abstracts

Background: Lipoatrophy (LA) was commonly associated with insulin use prior to the development of purified insulin in the 1970’s, and then has virtually disappeared. In the last few years, however reports of LA among patients using analogue insulin preparations have increased. We report a case series of 4 patients from a tertiary paediatric diabetes unit presenting with LA while on treatment with analogue insulin via a continuous s.c. insulin infusion pump (CSII).

Methods: Four patients have presented within the last 2 years with LA, from our clinic population of 328 patients.

Results: All four patients were on insulin Aspart via CSII for the management of type 1 diabetes (T1DM) (Table 1).

There was no statistically significant difference in HbA1c at the time of LA diagnosis compared to 3 months prior.

Conclusions: Lipoatrophy as a complication of insulin therapy in patients with T1DM is re-emerging. LA causes undesirable cosmetic appearances and may cause variable glycaemic control. We have not seen any cases with multiple injections, so it is possible that the continuous infusion of analogue insulin is an important factor. LA should be reported to drug companies and the Yellow Card system of adverse drug effects. This will facilitate observation of trend, and help monitor associations.