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Lipodystrophy is a disorder afflicting subcutaneous fat and can result in lipoatrophy or lipohypertrophy. Before the advent of recombinant human insulin, insulin-induced lipoatrophy was a common problem among insulin users. Lipoatrophy is a clinical condition characterized by localized loss of subcutaneous fat. The prevalence of lipoatrophy was reported to be as high as 24–55% with animal insulins (1). Fortunately, with the use of human insulin, lipoatrophy has become a rare complication (2). Lipohypertrophy is characterized by increased localized adipose tissue mass. Its prevalence is reported to be as high as 20–30% in people with type 1 diabetes using human insulin products (3).Lipodystrophy resulting from insulin use is localized to insulin injection sites, and its presence might affect insulin absorption. The pathophysiological mechanism of insulin-induced lipodystrophy remains to be determined. Although various mechanisms have been proposed, presence of high-titer anti-insulin antibodies and individual susceptibility to these conditions point toward an immune-mediated mechanism. Concurrent occurrence of lipoatrophy and lipohypertrophy in the same patient is uncommon and, to the best of our knowledge, has not been reported previously.A 12-year-old girl with type 1 diabetes for the past 3 years presented with inadequate glycemic control and significant unexplained glycemic variability. She was taking human regular insulin three times per day before meals and human NPH insulin before breakfast and dinner. She had localized lipoatrophy on the abdomen (noted for the past 3 months). Her weight, height, and BMI …

Concurrence of Lipoatrophy and Lipohypertrophy in Children With Type 1 Diabetes Using Recombinant Human Insulin: Two Case Reports