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Insulin Pump-Induced Lipoatrophy: Proposed Diagnostic and Management Algorithm.
Harsan Kanagaretnam1,2, Kajanan Parameshwaran1, Avinash Suryawanshi1
1Endocrinology Department, Concord Repatriation General Hospital, Concord, New South Wales 2139, Australia.
JCEM Case Reports
|August 1, 2025
Summary
Lipoatrophy, a rare complication of insulin therapy, can be managed effectively. This case report details successful treatment of abdominal wall lipoatrophy in a type 1 diabetes patient using site rotation and insulin analogue changes.
Area of Science:
- Endocrinology
- Dermatology
Background:
- Lipoatrophy, the localized loss of subcutaneous fat, is a rare but persistent complication of insulin therapy.
- Despite advancements in insulin formulations and delivery systems, lipoatrophy remains a clinical challenge.
Observation:
- A 58-year-old woman with type 1 diabetes mellitus developed significant abdominal wall lipoatrophy 4 months after starting insulin pump therapy.
- The lipoatrophy presented as localized fat loss at the insulin infusion sites.
Findings:
- Management involved changing the infusion cannula type, rotating insulin insertion sites, and switching to different insulin analogues.
- This multi-faceted approach led to the stabilization and complete resolution of lipoatrophy over a 16-month period.
Implications:
- A proposed diagnostic and management algorithm for lipoatrophy includes site rotation, cannula and insulin modifications, and potential adjunctive therapies.
- This case highlights the importance of individualized management strategies for insulin-induced lipoatrophy.
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