Phản Ứng Lipodystrophy Đối Với Insulin

American Journal of Clinical Dermatology - Tập 8 - Trang 21-28 - 2012
Régis P. Radermecker1, Gérald E. Piérard2, André J. Scheen1
1Division of Diabetes, Nutrition and Metabolic Disorders, Department of Medicine, University Hospital Sart Tilman, University of Liège, Liège, Belgium
2Division of Dermatopathology, University Hospital Sart Tilman, University of Liège, Liège, Belgium

Tóm tắt

Quản lý bệnh tiểu đường có thể dẫn đến các tác dụng phụ trên da. Ví dụ, tình trạng lipoatrophy hoặc lipohypertrophy có thể phát triển tại vị trí tiêm insulin. Lipohypertrophy vẫn là một biến chứng thường gặp của liệu pháp insulin bất kể nguồn insulin và phương thức tiêm như thế nào. Lipoatrophy ở các vị trí tiêm insulin được coi là tổn thương viêm trung gian bởi phức hợp miễn dịch; tuy nhiên, nó đã trở thành một sự kiện hiếm gặp kể từ khi insulin người ra đời. Ngày nay, việc truyền insulin liên tục dưới da (CSII) bằng cách sử dụng bơm xách tay và/hoặc tiêm insulin analog với chuỗi axit amin bị thay đổi so với insulin tự nhiên có thể gây ra lipodystrophy ở bệnh nhân tiểu đường. Một số báo cáo trường hợp mô tả sự phục hồi của lipoatrophy sau khi sử dụng CSII và/hoặc insulin analog tác dụng ngắn. Ngược lại, những trường hợp lipoatrophy đặc biệt đã xảy ra ở bệnh nhân nhận insulin analog lispro qua CSII. Các phản ứng lipodystrophy vẫn là một vấn đề tiềm ẩn khi quản lý bệnh nhân tiểu đường với các công nghệ liệu pháp insulin mới.

Từ khóa

#bệnh tiểu đường #insulin #lipodystrophy #lipoatrophy #lipohypertrophy #truyền insulin liên tục dưới da #insulin analog.

Tài liệu tham khảo

Ahmed I, Goldstein B.: Diabetes mellitus. Clin Dermatol 2006; 24: 237–46 Richardson T, Kerr D.: Skin-related complications of insulin therapy: epidemiology and emerging management strategies. Am J Clin Dermatol 2003; 4: 661–7 Píerard-Franchimont C, Hermanns-Lê T, Scheen A.: Cutaneous complications of insulinotherapy: a drug-related problem on the decline. Rev Med Li`ege 2005; 60: 564–5 Lawrence RD.: Local insulin reactions. Lancet 1925; 1: 1125–6 Schernthaner G.: Immunogenicity and allergenic potential of animal and human insulins. Diabetes Care 1993; 16 Suppl. 3: 155–65 Lapie`re ChM, Piérard GE, Hermanns JF.: Unusual extensive granulomatosis after long term use of plastic syringes for insulin injections. Dermatologica after long term use of plastic syringes for insulin injections. Dermatologica 1982; 165: 55–67 Paley RG, Tunbridge RE.: Dermal reactions to insulin therapy. Diabetes 1952; 1: 22–7 Arkins JA, Engoring NH, Lennon E.: The incidence of skin reactivity to insulin in diabetic patients. J Allergy 1962; 33: 69–72 Patterson R, Roberts M, Grammer LC:. Insulin allergy: re-evaluation after two decades. Ann Allergy 1990; 64: 459–62 Grammer LC.: Immunologic reaction to insulin and other proteins. Immunol Allergy Clin North Am 1998; 18: 809–16 Sola-Gazagnes A, Pecquet C.: Allergie á l’insuline en 2003. Paris: Journées de Diabétologie de l’Hôtel Dieu, Flammarion Médecine-Sciences, 2004: 161–79 Pickup J, Keen H.: Continuous subcutaneous insulin infusion at 25 years: evidence base for the expanding use of insulin pump therapy in type 1 diabetes. Diabetes Care 2002; 25: 593–8 Radermecker RP, Scheen AJ.: Continuous subcutaneous insulin infusion with short-acting insulin analogues or human regular insulin: efficacy, safety, quality of life, and cost-effectiveness. Diabetes Metab Res Rev 2004; 20: 178–88 Ratner RE, Phillips TM, Steiner M.: Persistent cutaneous insulin allergy resulting from high-molecular-weight insulin aggregates. Diabetes 1990; 39: 728–33 Oiknine R, Bernbaum M, Mooradian AD.: A critical appraisal of the role of insulin analogues in the management of diabetes mellitus. Drugs 2005; 65: 325–40 Hirsch IB. Insulin analogues. N Engl J Med 2005; 352: 174–83 Brange J, Owens DR, Kang S.: Monomeric insulins and their experimental and clinical implications. Diabetes Care 1990; 13: 923–54 Ottesen JL, Nilsson P, Jami J.: The potential immunogenicity of human insulin and insulin analogues evaluated in a transgene mouse model. Diabetologia 1994; 37: 1178–85 Radermecker RP, Scheen AJ.: Treatment of allergy to insulin using continuous subcutaneous insulin infusion with short-acting insulin analogues. Infusystems International 2004; 3: 1–5 Castera V, Dutour-Meyer A, Koeppel M.: Systemic allergy to human insulin and its rapid and long acting analogs: successful treatment by continuous subcutaneous insulin lispro infusion. Diabetes Metab 2005; 31: 391–400 Guinn TS, Bailey GJ, Mecklenburg RS.: Factors related to discontinuation of subcutaneous insulin infusion therapy. Diabetes Care 1988; 11: 46–51 Chantelau E, Lange G, Sonnenberg GE.: Acute cutaneous complications and catheter needle colonization during insulin-pump treatment. Diabetes Care 1987; 10: 478–82 Kahn CR, Rosenthal AS.: Immunologic reactions to insulin: insulin allergy, insulin resistance, and the autoimmune insulin syndrome. Diabetes Care 1979; 2: 283–95 McNally PG, Jowett NI, Kurinczuk JJ.: Lipohypertrophy and lipoatrophy phenoxycomplicating treatment with highly purified bovine and porcine insulins. Post-grad Med J 1988; 64: 850–3 Flagothier C, Piérard GE, Quatresooz P.: Cutaneous myospherulosis and membranous lipodystrophy: extensive presentation in a patient with severe steroid-induced dermal atrophy. J Eur Acad Dermatol Venereol 2006; 20: 457–60 Flagothier C, Quatresooz P, Piérard GE.: Electromagnetic lipolysis and semicircular lipoatrophy of the thighs. Ann Dermatol Venereol 2006; 133: 577–80 Hauner H, Stockamp B, Haaster B.: Prevalence of lipohypertrophy in insulin-treated diabetic patients and predisposing factors. Exp Clin Endocrinol Diabetes 1996; 104: 106–10 Fujikura J, Fujimoto M, Yasue S.: Insulin-induced lipohypertrophy: report of a case with histopathology. Endocr J 2005; 52: 623–8 Quatresooz P, Xhauflaire-Uhoda E, Piérard-Franchimont C.: Cellulite histopathology and related mechanobiology. Int J Cosmet Sci 2006; 28: 207–10 Raile K, Noelle V, Landgraf R.: Insulin antibodies are associated with type 1 diabetes. Exp Clin Endocrinol Diabetes 2001; 109: 393–6 Young RJ, Hannan WJ, Frier BM.: Diabetic lipohypertrophy delays insulin absorption. Diabetes Care 1984; 7: 479–80 Chowdhury TA, Escudier V.: Poor glycemic control caused by insulin induced lipohypertrophy. BMJ 2003; 327: 83–4 Hardy KJ, Gill GV, Bryson JR.: Severe insulin-induced lipohypertrophy successfully treated by liposuction. Diabetes Care 1993; 16: 929–30 Samdal F, Amland PF, Sandsmark M.: Diabetic lipohypertrophy treated with suction-assisted lipectomy. J Intern Med 1993; 234: 489–92 Radermecker RP, Scheen AJ.: Allergy reactions to insulin: effects of continuous insulin infusion and insulin analogues.Diabetes Metab Res Rev. In press Kim KT, Ahn SK, Choi EH.: Membranous lipodystrophy associated with insulin lipoatrophy. Int J Dermatol 1997; 36: 299–301 Murao S, Hirata K, Ishida T.: Lipoatrophy induced by recombinant human insulin injection. Intern Med 1998; 37: 1031–3 Mu L, Goldman JM.: Human recombinant DNA insulin-induced lipoatrophy in patient with type 2 diabetes mellitus. Endocr Pract 2000; 6: 151–2 Felner EI.: Human insulin-induced lipoatrophy. J Pediatr 2003; 142: 448 Atlan-Gepner C, Bongrand P, Farnarier C.: Insulin-induced lipoatrophy in type 1 diabetes: sta possible tumor necrosis factor-a-mediated dedifferentiation of adipocytes. Diabetes Care 1996; 19: 1283–5 Jermendy G, Nadas J, Sapi Z.: “Lipoblastoma-like” lipoatrophy induced by human insulin: morphological evidence for dedifferentiation of adipocytes? Diabetologia 2000; 43: 955–6 Reeves WG, Allen BR, Tattersall RB.: Insulin-induced lipoatrophy: evidence for an immune pathogenesis. BMJ 1980; 1: 1500–6 Beltrand J, Guilmin-Crepon S, Castanet M.: Insulin allergy and extensive lipoatrophy in child with type 1 diabetes. Horm Res 2006; 65: 253–60 Whitley TH, Lawrence PA, Smith CL.: Amelioration of insulin lipoatrophy by dexamethasone injection. JAMA 1976; 235: 839–40 Ramos AS, Farias MA.: Human insulin-induced lipoatrophy: a successful treatment with glucocorticoid. Diabetes Care 2006; 29: 926–7 Logwin S, Conget I, Jansa M.: Human insulin-induced lipoatrophy: successful treatment using a jet-injection device errpublished erratum appears in Diabetes Care. Diabetes Care 1996; 19: 255–6 Meyer L, Hadjadj S, Guerci B.: Lipoatrophic diabetes mellitus treated by continuous subcutaneous insulin infusion. Diabetes Metab 1998; 24: 544–6 Lougheed W, Albisser AM, Martindale HM.: Physical stability of insulin formulations. Diabetes 1983; 32: 424–32 Chantelau E, Lange G, Gasthaus M.: Interaction between plastic catheter tubings and regular insulin preparations used for continuous subcutaneous insulin-infusion therapy. Diabetes Care 1987; 10: 348–51 Melberg SG, Havelund S, Villumsen J.: Insulin compatibility with polymer materials used in external pump infusion systems. Diabet Med 1988; 5: 243–7 Van den Hove J, Jacobs M-C, Tennstedt D.: Allergic contact dermatitis from acrylates in insulin pump infusion sets. Contact Dermatitis 1996; 35: 108 Jolanki R, Kanerva L, Estlander T.: Allergic contact dermatitis from phenoxyethoxy ethylacrylates in optical fiber coating, and glue in an insulin pump set. Contact Dermatitis 2001; 45: 36–7 Saccabusi S, Boatto G, Asproni B.: Sensitization to methyl methacrylate in the plastic catheter of an insulin pump infusion set. Contact Dermatitis 2001; 45: 47–8 Boom BW, Van Driel LM.: Allergic contact dermatitis to epoxy resin infusion sets of an insulin pump.Contact Dermatitis1985; 12:280 Busschots AM, Meuleman V, Poesen N.: Contact allergy to components of glue in insulin pump infusion sets. Contact Dermatitis 1995; 33: 205–6 Corazza M, Maranini C, Aleotti A.: Nickel contact dermatitis due to needle of an insulin pump, confirmed by microanalysis. Contact Dermatitis 1998; 39: 144 Meier A, Weerakoon J, Dandona P.: Bilateral abdominal lipohypertrophy after continuous subcutaneous infusion of insulin. BMJ 1982; 283: 1539 Chantelau E, Reuter M, Schotes S.: Severe lipoatrophy with human insulin: successfully treated by CSII. Diabet Med 1993; 10: 580–1 Griffin ME, Feder A, Tamborlane WV.: Lipoatrophy associated with lispro in insulin pump therapy. Diabetes Care 2001; 24: 174 Ampudia-Blasco FJ, Hasbum B, Carmena R.: A new case of lipoatrophy with lispro insulin in insulin pump therapy. Diabetes Care 2003; 26: 953–4 Arranz A, Andia V, Lopez-Guzman A.: A case of lipoatrophy with lispro insulin without insulin pump therapy. Diabetes Care 2004; 27: 625–6 Ampudia-Blasco FJ, Girbes J, Carmena R.: A case of lipoatrophy with insulin glargine. Diabetes Care 2005; 28: 2983 Fineberg SE, Huang J, Brunelle R.: Effect of long-term exposure to insulin lispro on the induction of antibody response in patients with type 1 or type 2 diabetes. Diabetes Care 2003; 26: 89–96 Roper NA, Bilous RW.: Resolution of lipohypertrophy following change of short-acting insulin to insulin lispro. Diabet Med 1998; 15: 1063–4 Johansson U-B, Amsberg S, Hannerz L.: Impaired absorption of insulin aspart from lipohypertrophic injection sites. Diabetes Care 2005; 28: 2025–7 Lougheed WD, Zinman B, Strack TR.: Stability of insulin lispro in insulin infusion systems. Diabetes Care 1997; 20: 1061–5 Defelippis MR, Bell MA, Heyob JA.: In vitro stability of insulin lispro in continuous subcutaneous insulin infusion. Diabetes Technol Ther 2006; 8: 358–68 Burge MR, Carey JD.: Vitiligo associated with subcutaneous insulin lispro infusion in type 1 diabetes. Diabetes Care 2004; 27: 275–6 Kemp EH, Waterman EA, Weetman AP.: Autoimmune aspects of vitiligo. Autoimmunity 2001; 34: 65–77