Impact of ultrasound‐diagnosed lipohypertrophy subtypes on insulin regimen adjustments in patients with T1DM
Authors' conclusion
TDD reductions vary among patients with different subtypes of LH. Nodular hyperechoic LH may not require immediate dose adjustments. Patients with diffuse hyperechoic and hypoechoic LH necessitate bolus-focused dose reductions.
Study context
- Population
- Hospitalised T1D patients with disease duration ≥1 year; Lipohypertrophy (LH) by point-of-care US; CSII pump placed away from LH sites, dose titrated to glucose target
- Participants
- 288 patients
- Exposure
- LH subtypes vs LH free
- LH-0n = 104reference
- LH (LH-1)n = 114
- LH (LH-2)n = 62
- LH (LH-3)n = 8
- Outcome
- Insulin total daily dose (TDD) requirements after avoiding injection at LH sites
Main finding
As reported in the abstract
TDD and TDD/body weight after avoiding LH sites
- All LH+ groups had a decrease in total daily dose (TDD) and TDD/body weight after avoiding injections at lesion sites (paired t-test)
- all p < 0.05
Observational data: associations, not effects.
Further findings
| Outcome | LH-2 | LH-3 |
|---|---|---|
| Share of TDD reduction due to bolus insulin | 88.05% | 74.78% |
| Bolus reduction/TDD reduction | 8.55/9.71 IU/day | 18.12/24.23 IU/day |
Original publication
Impact of ultrasound‐diagnosed lipohypertrophy subtypes on insulin regimen adjustments in patients with T1DM. Diabet Med. Published 2 April 2025. doi:10.
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