Abstract
A 58-year-old manfrom Pakistan with a long-standing history of type 2 diabetes and diabetes-related complications and comorbidities presented to an endocrinologist. The patient reported that he has been on multidose insulin regimen for the last 20 years with insulin totaling over 250 units a day. Laboratory tests showed should the following review significant findings: (1) hemoglobin A1C level, >14%; (2) fasting glucose level, 398 mg/dL; and (3) creatinine level, 1.56 mg/dL. General physical examination revealed a middle-aged male patient with a body mass index of 23 kg/m2 and a large area of rubbery, hyperpigmented, necrotic masses below the umbilical line.
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