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Diabetes Metab Syndr. 2018 Sep;12(5):813-818. doi: 10.1016/j.dsx.2018.04.023. Epub 2018 Apr 10.

Insulin related lipodystrophic lesions and hypoglycemia: Double standards?

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Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples Italy; Coordinator of the Study Group on Injection Technique of AMD (Medical Association of Diabetology), Italy. Electronic address:
Endocrinology and Diabetes, San Raffaele Termini Institute, Rome, Italy.
Department of Internal Medicine, Campania University "Luigi Vanvitelli", Naples Italy.


Lipohypertophy (LH) is the most common skin complication of incorrect injection technique which does not only represent an aesthetic defect but also severely disrupts insulin pharmacokinetics/pharmacodynamics. As a consequence of that, hormone release is delayed and unexplained/unpredictable hypoglycemia occurs, both deteriorating metabolic control while negatively affecting adherence to treatment and quality of life. The economic burden due to unwanted intra-LH injections is accounted for by inappropriately high insulin requirements, increased emergency-related hospitalizations, and loss of work days. Greater attention has to be paid by diabetes care teams to education programs with periodic refreshers to achieve better metabolic control and reduce the economic burden of diabetes.


Diabetes; Injection technique; Insulin; Lipodystrophy; Lipohypertrophy

[Indexed for MEDLINE]

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