Insulin Aspart–Induced Lipoatrophy Treated Successfully With Glucocorticoid Injection

ABSTRACT Objective: To evaluate the management of insulin-induced lipoatrophic areas with local subcutaneous glucocorticoid injection. Methods: A 42-year-old woman with type 2 diabetes mellitus, who was taking biphasic insulin aspart for the last 3 years, presented with two areas of lipoatrophy of insulin injection sites on the anterior abdominal wall. It was associated with erratic glycemic control. We administered glucocorticoid injections (betamethasone) subcutaneously without mixing with insulin on the right-sided lipoatrophic area of the abdomen. The left-sided lesion served as a control. Results: After 6 weeks of treatment, lipoatrophy on the right side of the abdomen showed significant improvement in comparison to the left side, which was also documented by magnetic resonance imaging. Glycemic status was also improved. Conclusion: We observed significant improvement of lipoatrophy with glucocorticoid injection. Contrary to previous observations, betamethasone did not adversely affect the glycemic status. Furthermore, insulin requirement was also decreased.