In purely experimental systems, studies in lipoatrophic mice have shown that leptin deficiency plays a major role in causing the metabolic
complications of lipoatrophy.47, Colombo C, Cutson JJ, Yamauchi T et al.
Also interesting to see that dexamethasone can help with lipoatrophy-
For example Atlan-Gepner et al.42 describe the injection of a mixture of insulin and dexamethasone (4?g/U insulin) directly into lipoatrophic areas, which led to a marked improvement of the lesion with no modification of glycemic control. The mechanism behind this effect is probably related to the dedifferentiation of adipocytes during the formation of lipoatrophies.
But does this mean that an insulin injection is clastogenic?? I don't think insulin is changing DNA, yet it creates lipoatrophy.
Here's a study that found the response of mast cells, rather than cell death, in insulin injections.
Subcutaneous adipose biopsies showed an elevated population of tryptase-positive, chymase-positive degranulated mast cells.
An allergic response makes much more sense to me in understanding lipoatrophy in Copaxone use. But, that's also because I believe in the product and my husband uses it.