Lipohypertrophy in insulin-treated diabetes: Prevalence and associated risk factors
Citation:CunninghamMT, McKennaMJ(2013) Lipohypertrophyininsulin-treated diabetes:Prevalenceand associatedriskfactors.Journal
of Diabetes Nursing17:340–3 Article points
1. TheAmericanDiabetes Associationrecommends theearlyadditionofinsulin therapyinpeoplewithdiabetes whodonotmeettargetgoals. Thisguidancehasledtoan increaseinthenumberof peoplewithtype2diabetes requiringinsulintherapy. However,thisriseintheuseof insulincanleadtoproblems suchaslipohypertrophy.
2.Thisstudyaimedtoassessthe prevalanceoflipohypertrophy inagroupof55peoplewho weretakinginsulin.Thestudy foundthat51%ofthestudy samplehadlipohypertrophy.
3.Rotationofinjectionsites, frequencyofinsulininjections, andthedurationofinsulin useareallassociated withlipohypertrophy.
Key words
-Insulinusage -Lipohypertrophy -Siterotation
Mary Thérèse Cunningham, Malachi McKenna
The American Diabetes Association recommends the early addition of insulin therapy in people with diabetes who do not meet target goals. This guidance has led to an increase in the number of people with type 2 diabetes requiring insulin therapy. However, this rise in the use of insulin has led to an increase in complications, such as lipohypertrophy. Lipohypertrophy is defined an accumulation of subcutaneous fat tissue at a site where insulin has been injected continuously. This Irish study evaluated the prevalence of lipohypertrophy among 55 people treated with insulin. Furthermore, the authors aimed to determine the factors related to insulin use that may impact on lipohypertrophy. To do this each study participant was asked to answer six questions about their insulin usage, including duration and frequency of insulin use.
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191380 people with diabetes in Ireland, with a prevalence of 6.1% of the population. By 2030, it is thought that there will be approximately 278 850 people with the condition, with a prevalence of 7.5% in the population (International Diabetes Federation, 2012).
The American Diabetes Association (ADA, 2012) recommends the early addition of insulin therapy in people with diabetes who do not meet target goals. This guidance has led to an increase in the number of people with type 2 diabetes requiring insulin therapy. However, this rise in the use of insulin can lead to problems, such as more frequent episodes of hypoglycaemia, and lipohypertrophy, which will be the focus of this article.
of insulin therapy and is characterised by the occurrence of soft fatty swellings at the site of repeated insulin injections (Hambridge, 2007). Insulin absorption diminishes in the areas of lipohypertrophy. Not only is there a danger of hyperglycaemia but conversely, when the same dose of insulin is injected into an area without lipohypertrophy, there is an increased risk of hypoglycaemia (Vardar and Kizilci, 2007). This leads to erratic diabetes control, which puts the individual at risk of developing chronic complications. It is vital that doctors and nurses recognise this condition by inspecting insulin sites regularly and encouraging site rotation.
The principle aim of this study was to estimate the prevalence of lipohypertrophy and to evaluate associated risk factors.
he prevalence of diabetes is increasing and the International Diabetes
Federation estimates that there are