PREVALENCE OF LIPOHYPERTROPHY IN INSULIN-TREATED DIABETIC-PATIENTS AND PREDISPOSING FACTORS

In a cross-sectional study the frequency of insulin-induced lipohypert rophy at injection sites was assessed in 223 type 1 and 56 type 2 diab etic patients. 64 (28.7%) of the subjects with type 1 diabetes, but on ly 2 (3.6%) of those with type 2 diabetes presented clinical evidence of lipohypertrophy. In every second affected type 1 diabetic patient l ipohypertrophy developed within 2 years after starting insulin therapy . The occurrence of lipohypertrophy was independent of the insulin sou rce and mode of therapy. In a multivariate logistic regression analysi s young age, low body mass index, abdominal injection site and, partic ularly, missing rotation of injection site were significant independen t risk factors for the presence of insulin-induced lipohypertrophy. Av oidance of such areas led to a partial or full remission of tissue swe llings in 6 of 11 cases under observation for one year. In conclusion, lipohypertrophy is still a frequent complication of insulin therapy. To prevent such local skin reactions insulin-treated patients should b e more intensively trained to regularly change injection sites.