During a routine physical examination of a diabetic child, an obvious loss of subcutaneous tissue from the upper and middle portions of both arms was noted (fig. 1). This loss of tissue occurred at the site at which insulin had been injected. A photograph of this child taken a year previously showed that some atrophy, while not marked, had nevertheless been present at that time. A search of the literature revealed that a number of authors had recently described the same condition. Depisch1 and Barborka2 were the earliest to note the disappearance of fat from the subcutaneous tissue in diabetic patients as the result of the injection of insulin. Both of Barborka's cases occurred in women, while of Depisch's five cases, four occurred in women and one in a man. Shortly thereafter, Davison3 and Mentzer and Du Bray4 each reported a case in a woman. The
FISCHER AE. THE FREQUENCY OF ATROPHY OF THE SUBCUTANEOUS FAT FOLLOWING THE INJECTION OF INSULIN. Am J Dis Child. 1929;38(4):715–720. doi:10.1001/archpedi.1929.01930100035003
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