Treatment for diabetic lipoatrophy? (Photo)

Question

I have been a type 1 diabetic for over 30 years and have experienced lipoatrophy at insulin injection sites. Some areas are much worse than others. I have previously had liposuction and fat grafting to correct areas of atrophy and hypertrophy but unfortunately the grafts didn’t last long. I’m looking for other treatment options as some spots are quite significant.

Zoran Potparic, MD · Answer

It would be hard to suggest anything different than liposuction and fat grafting since condition is caused due deep scars in the fat tissue. Since there are multiple sites of deformity, treatment is further complicated. Use of nano fat grafts and repeated procedures of fat grafting may be considered? Good luck.

Connie Hiers, MD, FACS · Answer

Fat transfers are not going to do well while you are on insulin. You could try liposuction overall to have less fat, or Sculptra injections to fill in the dents.

Mats Hagstrom, MD (license on probation) · Answer

Collecting loss of fat from a variety of circumstances with fat transfer can be tricky. In order for fat grafting to be successful there has to be sufficient host tissue to support the grafted fat.
For that reason, fat grafting is far more successful when volume depletion is not already present.
This is one of the reasons why fat transfer does not have good success, correcting overzealous previous Liposuction.
To build up the volume in areas of previously fat loss often requires multiple rounds of fat transfer grafting small amount each time.
Injecting insulin in the same location repeatedly can lead to these problems. Alternating injections sites with consistency is the best way to avoid these contour irregularities.
There really are not good alternatives other than fat grafting currently available. They use a Fillers will be cost prohibitive though their use will probably be temporarily successful.
Hypertrophy is much easier to manage than atrophy.
It’s a difficult situation to treat once established. The best long-term solution is to eliminate the problem by not re-injecting in the same location. Perhaps that’s easier said than done. I don’t have first-hand experience having to give myself daily injections of insulin.
Just like people who have had poorly done liposuction the problem is inherently difficult to treat or solve.
Best,
Mats Hagstrom, MD

Treatment for diabetic lipoatrophy? (Photo)

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