Roper N A, Bilous R W
Diabetes Care Centre, Middlesbrough General Hospital, UK.
Diabet Med. 1998 Dec;15(12):1063-4. doi: 10.1002/(SICI)1096-9136(1998120)15:12<1063::AID-DIA706>3.0.CO;2-V.
Lipohypertrophy as a local complication of insulin therapy is well recognized. Despite improvements in insulin purity and the introduction of recombinant human insulin its prevalence has remained high. Rotation of injection sites can reduce the frequency of the problem but does not abolish it. The importance of this complication is not only cosmetic but also in its impact on insulin absorption, and hence glycaemic control. We report a patient who had intractable lipohypertrophy with human recombinant insulin but experienced no such problem when converted onto the insulin analogue lispro. We suggest that the faster speed of absorption of insulin lispro may lead to less hypertrophic stimulation of subcutaneous adipocytes. This difference may be clinically useful in susceptible individuals.
胰岛素治疗的局部并发症——脂肪增生已得到充分认识。尽管胰岛素纯度有所提高，且重组人胰岛素问世，但该并发症的发生率仍然很高。注射部位轮换可降低此问题的发生频率，但并不能杜绝。这一并发症的重要性不仅体现在外观方面，还在于其对胰岛素吸收进而对血糖控制的影响。我们报告一例患者，使用重组人胰岛素时出现难治性脂肪增生，而换用胰岛素类似物赖脯胰岛素后未出现此类问题。我们认为，赖脯胰岛素更快的吸收速度可能导致对皮下脂肪细胞的增生性刺激减少。这种差异对于易感个体可能具有临床应用价值。
