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      Prevalence of lipohypertrophy in insulin-treated diabetic patients and predisposing factors.

      Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association
      Adult, Cross-Sectional Studies, Diabetes Mellitus, Type 1, complications, drug therapy, Diabetes Mellitus, Type 2, Female, Humans, Insulin, adverse effects, Lipodystrophy, chemically induced, epidemiology, Male, Middle Aged, Odds Ratio, Prevalence, Regression Analysis, Risk Factors

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          Abstract

          In a cross-sectional study the frequency of insulin-induced lipohypertrophy at injection sites was assessed in 223 type 1 and 56 type 2 diabetic patients. 64 (28.7%) of the subjects with type 1 diabetes, but only 2 (3.6%) of those with type 2 diabetes presented clinical evidence of lipohypertrophy. In every second affected type 1 diabetic patient lipohypertrophy developed within 2 years after starting insulin therapy. The occurrence of lipohypertrophy was independent of the insulin source and mode of therapy. In a multivariate logistic regression analysis young age, low body mass index, abdominal injection site and, particularly, missing rotation of injection site were significant independent risk factors for the presence of insulin-induced lipohypertrophy. Avoidance of such areas led to a partial or full remission of tissue swellings 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 be more intensively trained to regularly change injection sites.

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