Lipoatrophy in a Girl With Type 1 Diabetes: Beneficial Effects of Treatment With a Glucocorticoid Added to an Insulin Analog

Lipoatrophy has been reported in association with the use of human insulin analogs (1). We report on a girl with severe lipoatrophy who was treated with betamethasone added to the insulin analog, after which the areas of lipoatrophy improved. A 7-year-old girl with type 1 diabetes, treated with insulin-aspart by continuous subcutaneous insulin infusion, developed areas of lipoatrophy at her insulin infusion sites, which initially only involved the buttocks. A few months later, areas of lipoatrophy were also seen on her thighs. The areas of lipoatrophy on her left and right buttocks measured 7 × 7 cm and 7 × 6 cm, respectively. Laboratory investigation excluded the presence of insulin antibodies. A skin biopsy was not performed. Initially, insulin-aspart was substituted with insulin-lispro. Because …