Reduced Skin Thickness with Pump Administration of Insulin

To the Editor: We described thick, waxy skin in adolescents with long-standing diabetes who also had limited joint mobility, delayed sexual maturation, and statural defect. 1 More recently, the association of limited joint mobility with early microvascular disease has suggested that comparable changes occur in the connective tissue of the vessels, as in the periarticular and skin tissues. 2 The following results indicate that changes in skin thickness may reflect the level of control of diabetes. Four patients who were receiving insulin by portable-pump infusion 3 had periodic measurement of skin thickness over a three-month period. We used an Ecoline 20A Ultrasonoscope (Smith . . .