Lipoatrophic diabetes mellitus treated by continuous subcutaneous insulin infusion.

This case report evaluated continuous subcutaneous insulin infusion (CSII) in a 50-year-old Caucasian woman who suffered from partial lipodystrophy and severely insulin-resistant diabetes mellitus. Intensive insulin therapy (three daily injections) failed to provide good metabolic control (HbA1c ranging from 10 to 12%). Even though the patient had very thin subcutaneous tissue, CSII was initiated and proved highly efficient, improving blood glucose control considerably (HbA1c ranging from 7.5 to 8.5%), but with no decrease in the daily insulin requirement (2 IU/kg/day). Plasma triglycerides were also greatly improved (from 16.5 to 3.7 mmol/l). Thus, this study indicates that CSII is suitable for patients with lipoatrophy and insulin-resistant diabetes mellitus.