LAUSR

A 46-year-old Japanese woman with type 2 diabetes noticed a depression in her right anterior abdomen where she had previously injected insulin for approximately 9 months (human neutral protamine Hagedorn insulin and insulin lispro), and this lesion expanded to her right groin. About 18 months after the insulin injections were stopped, a second depression lesion appeared on her left buttock where she had never injected insulin (Fig. 1 A–C ). Computed tomography showed lipoatrophy of the right submandibular region, right anterior abdomen, and left buttock sites (Fig. 1 D and E ). Laboratory data showed high values of HbA1c (8.9% [73 mmol/mol]) and fasting insulin levels (1,163 µU/mL). The insulin antibody titer was over 5,000 nU/mL, and the binding rate was 86.7%. Insulinoma was negative, with no increase in her fasting C-peptide level, …