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Nurs Child Young People. 2019 Nov 7;31(6):18-22. doi: 10.7748/ncyp.2019.e1203. Epub 2019 Oct 17.

Frequency of injection site assessment for lipohypertrophy in children and young people with type 1 diabetes.

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Paediatric diabetes, Croydon University Hospital, Croydon, England.


Children and young people with diabetes are at high risk of developing lipohypertrophy (LH) as a result of daily injections of insulin. LH is characterised by dense nodules that are palpable beneath the skin's surface. A retrospective audit investigated the frequency of injection site assessment in children and young people attending a diabetes clinic over one year. The audit was conducted using the medical records of 76 eligible patients with type 1 diabetes, all treated with multiple daily injections or continuous subcutaneous insulin infusions for a minimum of six months from the audit start date. None of the participants had their injection sites assessed at every clinic visit. Just under one third ( n =23, 30%) received at least one injection site assessment within the audit year. Of these, 11 had LH detected. HbA 1c and average blood glucose levels were higher in those with LH, which was deemed significant. There was a slight increase in glucose variation in those with LH compared with those without LH. However, this result was not statistically significant. The frequency of injection site assessment is low in children and young people but the prevalence of LH is high. This means it is essential to improve healthcare professionals' injection technique education and assessment skills to minimise the risk of patients developing LH.


child health; diabetes; glycaemic control; type 1 diabetes


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