[Insulin-induced lipoatrophy in children].

Area of Science:

• Endocrinology
• Pediatrics
• Dermatology

Background:

• Insulin-induced lipoatrophy is a rare complication of insulin therapy, historically decreasing but recently re-emerging.
• Traditional management involves altering injection sites or insulin types/preparations.
• Insulin pump therapy presents unique challenges for managing localized complications like lipoatrophy.

Observation:

• Four pediatric patients on insulin pump therapy developed severe lipoatrophy.
• Standard interventions, such as changing injection sites, were ineffective in these cases.
• The study observed the outcomes of various treatment modifications in these children.

Findings:

• Switching insulin preparation resolved lipoatrophy in one patient.
• In the remaining three patients, changing insulin preparation or adding topical pimecrolimus/sodium cromoglicate prevented new atrophy formation.
• These findings suggest alternative treatment strategies beyond traditional methods.

Implications:

• Changing insulin preparation is a viable strategy for managing insulin-induced lipoatrophy in pediatric patients using insulin pumps.
• Combination therapy with topical agents may offer additional benefits in preventing or treating this complication.
• Further research is warranted to elucidate the mechanisms and optimize treatment protocols for insulin-induced lipoatrophy.