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JAMA. 1950;142(17):1350-1353. doi:10.1001/jama.1950.02910350020007.
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Although isolated reports of the occurrence of insulogenic lipodystrophies have been appearing since 1926, the development of local areas of subcutaneous fat atrophy or of persistent hard, nodular swelling at the site of insulin injections is still generally ignored or lightly considered in most textbooks and monographs on diabetes mellitus.

In 1942 Marble and Smith1 reviewed the literature and studied 500 unselected diabetic patients, almost one fifth of whom were found to have areas of lipoatrophy at the site of the insulin injections. After careful histologic studies and other investigations, they could prove no relationship to any of the factors involved in the administration of insulin except possibly that of repeated trauma.

In my personal experience the incidence of insulogenic lipodystrophies reaches close to 60 per cent of all diabetic patients who have been taking daily injections of insulin for periods longer than six months before coming to my


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