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Lipodystrophy Reactions to Insulin

Effects of Continuous Insulin Infusion and New Insulin Analogs

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Abstract

Management of diabetes mellitus can be responsible for cutaneous adverse events. For example, lipoatrophy or lipohypertrophy can develop at the site of insulin injections. Lipohypertrophy remains a frequent complication of insulin therapy irrespective of the insulin source and mode of administration. Lipoatrophy at insulin injection sites is considered to be an immune complex-mediated inflammatory lesion; however, it has become a rare event since the advent of human insulin. Nowadays, continuous subcutaneous insulin infusion (CSII) using a portable pump and/or injections of insulin analogs with an altered amino acid sequence compared with native insulin may cause lipodystrophy in diabetic patients. Some case reports describe the recovery of lipoatrophy following the use of CSII and/or short-acting insulin analogs. Conversely, exceptional cases of lipoatrophy have occurred in patients receiving lispro insulin analog via CSII. Lipodystrophy reactions remain a potential problem when managing diabetic patients with new insulin therapy technologies.

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Acknowledgments

No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review.

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Authors and Affiliations

  1. Division of Diabetes, Nutrition and Metabolic Disorders, Department of Medicine, University Hospital Sart Tilman, University of Liège, Liège, B-4000, Belgium

    Régis P. Radermecker & André J. Scheen

  2. Division of Dermatopathology, University Hospital Sart Tilman, University of Liège, Liège, Belgium

    Gérald E. Piérard

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  1. Régis P. Radermecker
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  2. Gérald E. Piérard
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  3. André J. Scheen
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Correspondence to Régis P. Radermecker.

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Radermecker, R.P., Piérard, G.E. & Scheen, A.J. Lipodystrophy Reactions to Insulin. Am J Clin Dermatol 8, 21–28 (2007). https://doi.org/10.2165/00128071-200708010-00003

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