Endocrine Abstracts

JOINT1747

Background: As a consequence of insulin therapy in diabetes mellitus, a variety of local skin reactions may occur, the most common is Lipohypertrophy (LH). This study aimed to determine the prevalence and associated risk factors of insulin-induced LH.

Patients and methods: We performed a cross-sectional study including insulin-treated patients for more than one year from the endocrinology department of Rabta Hospital in Tunis between February and August 2024.

Results: We included 60 patients with a sex-ratio of 0.58 and 75% type 2 diabetes mellitus patients. Mean age, duration of disease and period of insulin therapy were respectively 54.8±16.7; 17.2±9.4 and 11.9±8.4 years. LH prevalence was 60%. Female gender (P = 0.02, OR[CI95%:1.4-13] =4.3), lack of assistance from a third party (LATP) (P = 0.03, OR[CI95%:1,1-11,7] =3.7) and concentrating insulin in a small area (P<0.001, OR[CI95%:9.8-38.9]= 3,7) were associated with higher prevalence of LH. Duration of disease, body mass index, body weight-adjusted dose, duration of insulin use, needle length and reuse, rate of rotating injection site, and cold insulin injection weren’t associated with LH. Multivariate analysis revealed that female gender, LATP and not spacing insulin injections were independently associated with LH. The strongest factor associated with LH was failure in spacing injections in the same area (OR_a=[CI95%:3.8-359.5] =37).

Discussion and Conclusion: Insulin-induced LH is a common complication in diabetes management. Female gender, LATP and not spacing injections are independently associated with LH. The most prominent factor was inadequate spacing of injections within the same area. Based on our and previous studies [1,2], it is important to examine injection sites and educate patients on prevention of lipodystrophy.

References: 1. Lombardo F, Bombaci B, Alibrandi A, Visalli G, Salzano G, Passanisi S. The Impact of Insulin-Induced Lipodystrophy on Glycemic Variability in Pediatric Patients with Type 1 Diabetes. Children (Basel). 20 juill 2022;9(7):1087.2. Thewjitcharoen Y, Prasartkaew H, Tongsumrit P, Wongjom S, Boonchoo C, Butadej S, et al. Prevalence, Risk Factors, and Clinical Characteristics of Lipodystrophy in Insulin-Treated Patients with Diabetes: An Old Problem in a New Era of Modern Insulin. Diabetes Metab Syndr Obes. 2020;13:4609–20.