Evaluation of Lipohypertrophy in Patients With Type 1 Diabetes Mellitus on Multiple Daily Insulin Injections or Continuous Subcutaneous Insulin Infusion
Authors' conclusion
USG might be an effective approach for detecting and evaluating the severity of LH. MDII might cause more severe LH than CSII in patients with T1DM. In this study, LH was found to be associated mostly with incorrect rotation technique and a history of ketosis.
Study context
- Population
- Patients with T1D treated with MDI or continuous subcutaneous insulin infusion (CSII) for at least 1 year
- Participants
- 66 patients
- Exposure
- MDI vs CSII
- Multiple daily insulin injections (MDII)n = 35
- CSIIn = 31reference
- Outcome
- Lipohypertrophy (LH) detected by palpation and ultrasonography (USG), and LH severity
Main finding
As reported in the abstract
LH detected with USG
P = 0.144
- Lipohypertrophy (LH) detection rate significantly higher with ultrasonography (USG) than palpation in the whole group
- P < 0.001
Observational data: associations, not effects.
Further findings
Advanced LH · LH more severe with MDII
P = 0.013
Factors associated with LH and LH severity
- Longer diabetes duration and infusion set use; higher BMI, hypoglycemia and complication rates with LH vs without LH
- P < 0.05
- Positive correlation of LH severity with HbA1c and insulin dose
- P < 0.05, for both
- MDII, incorrect rotation and history of ketosis most related to LH severity (multiple linear regression)
- P < 0.05
Original publication
Evaluation of Lipohypertrophy in Patients With Type 1 Diabetes Mellitus on Multiple Daily Insulin Injections or Continuous Subcutaneous Insulin Infusion. Endocr Pract. Published 22 November 2022. doi:10.
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