What is lipohypertrophy?
Lipohypertrophy is when fatty lumps appear on the surface of the skin and is a fairly common side effect of insulin injections.
This will usually occur if multiple injections are administered to roughly the same part of the skin over a period. In fact, up to 50 percent of people with type 1 diabetes experience it at some point.
When the skin becomes lumpy, it may mean that if insulin is injected into the lumpy area, it won’t be absorbed consistently, which can mean the insulin takes longer to be absorbed, leading to higher than normal blood glucose levels, or can get absorbed too quickly, leading to hypoglycemia.
Why does this happen?
This happens due to the action of insulin on the fat cells. Insulin can actually cause fat cells to increase in size. It is generally seen when one uses the same area for insulin injection or infusion. It happens most often in areas that are easiest to inject insulin or place infusion sets-on both sides of the belly button and on the sides of the thighs.
Symptoms of lipohypertrophy
The main symptom of lipohypertrophy is the development of raised areas under the skin. These areas may have the following characteristics:
- small and hard or large and rubbery patches
- surface area over 1 inch in diameter
- a firmer feel than elsewhere on the body
Areas of lipohypertrophy can cause delays in absorption of medication administered to the affected area, like insulin, which can result in difficulties controlling blood sugar.
Lipohypertrophy areas should not:
- be hot or warm to the touch
- have redness or unusual bruising
- be noticeably painful
These are all symptoms of a potential infection or injury. See a doctor as soon as possible if you have any of these symptoms.
There are several factors that increase your chances of getting lipohypertrophy. The first is injections at the same location too often, which can be avoided by consistently rotating your injection sites. Using a rotation calendar can help you keep track of this.
Another risk factor is reusing the same needle more than once. Needles are dulled after each use. The more you reuse your needles, the greater your chance of developing this condition. One study found that 46 percent of people who developed lipohypertrophy reused needles. Poor blood control, how long you have had diabetes, needle length, and duration of insulin therapy are also risk factors.
How do I know if I have lipohypertrophy
Keeping your fingers stiff, run the edge of your hand across your injection sites. If any lumps are there, you will be able to feel them.
Treatment for lipohypertrophy will usually involve making sure you don’t inject the affected area of skin until it has fully healed. It is recommended avoiding injecting into the affected area for at least 2 to 3 months. It can take up to 12 months for Lipohypertrophy to disappear. In severe cases, liposuction, a procedure that removes fat from under the skin, may be used to reduce the bumps. Liposuction gives immediate results and can be used when avoiding the injection site hasn’t resolved the issue.
How is it prevented?
Rotate your injection/infusion sites! It is important to use different sites to prevent lipohypertrophy. You might want to use a calendar or body map to be sure that you are rotating your sites frequently. Avoid areas that have lipohypertrophy and allow them to heal before using them for your injection/infusion site. This practice is known as rotating your injection site. Ideally, you should aim to keep each new injection spot at least an inch away from your previous injection sites.
Lipohypertrophy can affect the way your body absorbs insulin, you may be at increased risk for hyperglycemia (high blood glucose levels) or hypoglycemia (low blood glucose levels). Both are serious complications of diabetes. Because of this, it’s a good idea to test your glucose levels if you’re receiving an insulin injection in an affected area.
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Garry (Type 1)
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