# Insulin Pump-Induced Lipoatrophy: Proposed Diagnostic and Management Algorithm

## TL;DR

A 58-year-old woman with type 1 diabetes developed abdominal lipoatrophy from insulin pump therapy, which improved with changes in treatment and site rotation.

## Contribution

Proposes a new diagnostic and management algorithm for insulin pump-induced lipoatrophy.

## Key findings

- Abdominal lipoatrophy occurred 4 months after starting insulin pump therapy.
- Changing cannula type, rotating sites, and switching insulin analogues led to improvement.
- Topical sodium cromoglycate and corticosteroids are suggested as potential adjunctive therapies.

## Abstract

Lipoatrophy, the localized loss of subcutaneous fat, is a rare complication of insulin therapy that persists despite advancements in insulin formulations and delivery systems. This case report describes a 58-year-old woman with type 1 diabetes mellitus who developed considerable abdominal wall lipoatrophy 4 months after initiating insulin pump therapy. Management included changing the infusion cannula type, rotating insertion sites, and switching insulin analogues, resulting in stabilization and complete improvement of lipoatrophy over 16 months. A diagnostic and management algorithm is proposed, incorporating site rotation, cannula and insulin type modifications, and potential adjunctive therapies including topical sodium cromoglycate and corticosteroids.