Lipohypertrophy and Glomerulonephritis after the Use of Aprotinin in an Insulin-Dependent Diabetic

To the Editor: Although resistance to subcutaneously injected insulin was described in 1978, no consistent mode for its treatment has emerged.¹ Aprotinin has been shown to improve the absorption of insulin from the subcutaneous injection sites² and has also been used effectively in cases of resistance to the subcutaneous infusion of insulin in the short term.^3,4 We report on a case that demonstrates some complications associated with long-term subcutaneous therapy with aprotinin. A 15-year-old girl with poorly controlled insulin-dependent diabetes mellitus and resistance to subcutaneously injected insulin (she required more than 3000 units per 24 hours) in the absence of.