Do you have weird lumps near your insulin injection sites?
It is a common complication of insulin injections that are often forgotten in patient education. This condition is called lipohypertrophy.
Let me break it down for you: lipo – fat, hyper – increased, trophy – disorder (or it goes something like that). It is an abnormal accumulation of fat due to the enlargement of fat cells and is commonly found in patients who receive frequent, multiple injections.
Lipohypertrophy occurs when patients are not properly educated and use the same injection site too often. It is more common in type 1 diabetics compared to type 2 diabetics, although it is still unclear why. Unfortunately, patients often use these lipohypertrophic sites for insulin injection as they tend to be less painful compared to other sites. This makes the lumps bigger and interferes with the insulin regimen therapy as well as leading to delayed insulin absorption.
Patients that start insulin therapy are often taught to rotate their injection sites, injecting about an inch or two from the last injection site. Where I am from, some diabetics are not as financially privileged or are not educated enough, which force them to sometimes reuse insulin needles. This habit increases the risk of lipohypertrophy as needles become dull after each use. One study found that 46% of patients with lipohypertrophy tend to reuse their insulin needles.
Patients can also use a diary or phone app to keep track of insulin sites.
When rotating your injection sites, inform your doctor when you switch from one region to another. The abdomen absorbs insulin the fastest, followed by the arm, the thigh, and the buttocks. Check your injection sites regularly for signs of lipohypertrophy. It may not appear as a lump at first, but the area may seem firmer and less painful compared to other areas of the skin.
If you have lipohypertrophy:
Try to avoid injecting at the site for 2 weeks to 3 months, depending on the size of the lumps. If caught early, these lumps can regress. Although these lumps are not painful, it may eventually be visually distressing for patients. Severe lipohypertrophy can be managed with cosmetic surgery.
Lastly, have your doctor inspect your injection sites at least annually for possible lipohypertrophy.
[expand title=”References“]
Ask Joslin: Lumps near injection sites. Joslin Diabetes Center. 2015.
Pietrangleo A, Gotter A. Lipohypertrophy. Healthline. 2016.
Kadiyala P, Walton S, Sathyapalan T. Insulin induced lipohypertrophy. The British Journal of Diabetes and Vascular Disease. 2014; 14(4):131-133.
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