Lipoatrophy in children with type 1 diabetes: an increasing incidence?

J Diabetes Sci Technol. 2015 Mar;9(2):206-8. doi: 10.1177/1932296814558348. Epub 2014 Nov 18.


The objectives were to evaluate the current prevalence of lipoatrophy at insulin injection sites in young patients with type 1 diabetes. Standardized examination of insulin injection sites in all 678 patients with type 1 diabetes treated in 2013 in our outpatient clinic were conducted. In case of lipoatrophy photo documentation and standardized interview with parents and patients were performed. We identified a total of 16 patients (43.8% male) with lipoatrophy (overall prevalence 2.4%). The current mean age (±SD) of the affected patients was 14.4 ± 3.9 years, age and diabetes duration at onset of lipoatrophy were 11.5 ± 3.8 years and 5.4 ± 3.6 years, respectively. All patients were using analogs at the onset of lipoatrophy. In all, 14 of 16 patients (87.5%) were on insulin pump compared with 52% without lipoatrophy (P = .0018). The use of steel needle and Teflon catheter was equal between the pump patients. Concomitant autoimmune diseases were present in 37.5% of the patients (thyroiditis: n = 3, thyroiditis and celiac disease: n = 2, celiac disease: n = 1) compared with 15.0% in those without lipoatrophy (P = .0128). Lipoatrophy was present in young patients treated with modern insulins and pumps; however, the prevalence was relatively low as expected with the use of modern insulins. Our data may support the hypothesis that a constant mechanical element such as a subcutaneous catheter may trigger the development of lipoatrophy, particularly in those patients with more than 1 autoimmune disease.

Keywords: CSII; catheters; injection sites; insulin analogs; lipoatrophy.

MeSH terms

  • Adolescent
  • Atrophy / chemically induced
  • Atrophy / epidemiology
  • Child
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Female
  • Humans
  • Hypoglycemic Agents / administration & dosage
  • Hypoglycemic Agents / agonists*
  • Incidence
  • Injections, Subcutaneous
  • Insulin / administration & dosage
  • Insulin / adverse effects*
  • Insulin Infusion Systems
  • Male
  • Prevalence
  • Subcutaneous Fat / pathology*


  • Hypoglycemic Agents
  • Insulin