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Unexpected evolution of a monster case of insulin-induced skin lipohypertrophy

S Gentile1, G Guarino1, F Strollo2

  • 1Department of Internal Medicine, Campania University ''Luigi Vanvitelli'', Naples, Italy; Nefrocenter Research Netwofk, Torre del Greco, Italy.

Diabetes Research and Clinical Practice
|November 6, 2023
PubMed

In this journal, in 2020, we published the case of a 74-year-old female outpatient with type-2 diabetes mellitus who self-injected insulin four times a day according to the basal-bolus regimen, with an high glycemic variability and an high rate of severe hypoglycemic episodes. Three years before, we had found two extraordinarily large skin lipohypertrophies, with large underlying fluid collections with high insulin concentration. A long educational and intensive training completely repaired the skin lesions with the disappearance of the subcutaneous insulin reservoirs. Glycemic variability has been reduced dramatically, severe hypoglycemia has almost completely disappeared and the daily dose of insulin has been reduced by 38%. However, this extraordinary, albeit unexpected, result was achieved in five years.

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