Resolution of lipohypertrophy following change of short-acting insulin to insulin lispro (Humalog).
Lipohypertrophy as a local complication of insulin therapy is well recognized. Despite improvements in insulin purity and the introduction of recombinant human insulin its prevalence has remained high. Rotation of injection sites can reduce the frequency of the problem but does not abolish it. The importance of this complication is not only cosmetic but also in its impact on insulin absorption, and hence glycaemic control. We report a patient who had intractable lipohypertrophy with human recombinant insulin but experienced no such problem when converted onto the insulin analogue lispro. We suggest that the faster speed of absorption of insulin lispro may lead to less hypertrophic stimulation of subcutaneous adipocytes. This difference may be clinically useful in susceptible individuals.
Roper
N A
NA
Diabetes Care Centre, Middlesbrough General Hospital, UK. n.a.roper@ncl.ac.uk
Bilous
R W
RW
D000273:Adipose Tissue / Q000187:drug effects / Q000473:pathology*; D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D006801:Humans; D006984:Hypertrophy / Q000139:chemically induced / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007328:Insulin / Q000009:adverse effects* / Q000031:analogs & derivatives* / Q000627:therapeutic use; D061268:Insulin Lispro; D061389:Insulin, Regular, Pork; D008297:Male; D011994:Recombinant Proteins / Q000009:adverse effects
D007004:Hypoglycemic Agents; D007328:Insulin; D061268:Insulin Lispro; D061389:Insulin, Regular, Pork; D011994:Recombinant Proteins; C000006:insulin, neutral