title: Lipoatrophy with insulin analogues in type I diabetes.
abstract: Lipoatrophy is a rare complication of treatment with insulin analogues. It has been reported with insulin Lispro (Eli Lilly, Indianapolis, Indiana, USA) and insulin Glargine (Sanofi-Aventis, Paris, France). To our knowledge, this is one of the first reports of lipoatrophy with Aspart, biphasic Aspart and Detemir insulin analogues (Novo Nordisk, Bagsvaerd, Denmark). We report the cases of four children with type I diabetes who were commenced on NovoMix 30 or NovoRapid/Levemir insulin injections. They developed lipoatrophy at the injection sites after 2-3 years of treatment. In two of our patients, lipoatrophy resolved when the injection sites were changed, suggesting that local factors could be the cause of lipoatrophy. However, lipoatrophy developed at the new sites in the other two patients, requiring a change of insulin preparation. Regular examination of the injection sites facilitated early detection of lipoatrophy in our patients. Lipoatrophy completely resolved over 1-2 years in all patients with no recurrence after 3-4 years of follow-up.
authors.affiliation: Jenny Lind Children's Department, Norfolk and Norwich University Hospital, UK.
authors.forename: Amir
authors.initials: A
authors.lastname: Babiker
authors.forename: Vipan
authors.initials: V
authors.lastname: Datta
mesh_terms: D000293:Adolescent; D061265:Biphasic Insulins; D002648:Child; D002675:Child, Preschool; D003923:Diabetes Mellitus, Lipoatrophic / Q000139:chemically induced; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D007328:Insulin / Q000009:adverse effects / Q000031:analogs & derivatives*; D061267:Insulin Aspart; D000069057:Insulin Detemir; D007336:Insulin, Isophane; D049528:Insulin, Long-Acting; D008060:Lipodystrophy / Q000139:chemically induced*
chemical_list: D061265:Biphasic Insulins; D007004:Hypoglycemic Agents; D007328:Insulin; D049528:Insulin, Long-Acting; C557564:insulin aspart, insulin aspart protamine drug combination 30:70; D000069057:Insulin Detemir; D007336:Insulin, Isophane; D061267:Insulin Aspart