A woman with poorly controlled type 1 diabetes and pruritic papules on her buttocks

摘要

A 45-year-old woman with long-standing poorly controlled type 1 diabetes had recently been omitting insulin doses due to family stress. She presents with itchy skin-coloured papules on her buttocks and extensor surfaces that she first noticed two weeks ago (Figure 1). Her HbA_1c was 120 mmol/mol (13.1%) and she had declined statin therapy for hyperlipidaemia previously. At this review her triglycerides were 60.8 mmol/L and total cholesterol was 18.0mmol/L.