Insulin lipodystrophy and lipohypertrophy

Mokta, Jatinder; Mokta, Kiran; Panda, Prashant

doi:10.4103/2230-8210.113788

Cited by 21 publications

(17 citation statements)

References 4 publications

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“…Insulin absorption at these sites is unpredictable, which creates the prerequisites for hyperglycemia or hypoglycemia. [1][2][3][4][5][6]8,9 A key element in prevention of this complication is the education of patients with diabetes. They should be instructed to alternate the injection sites, to observe the skin, and not to use the same needle for a long period of time (up to 12 times).…”

Section: Discussionmentioning

confidence: 99%

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Insulin-induced Lipoatrophy in a Patient on Insulin Analogue Therapy: a Case Report

Yanachkova

Staynova

2020

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Insulin-induced lipoatrophy is a rare skin complication in patients with diabetes mellitus. It is characterized primarily by localized subcutaneous atrophy of the fatty tissue at the site of frequent insulin injection. We report a clinical case of a 38-year-old woman with lipoatrophy, developed during treatment with insulin analogues. Lipoatrophic zone formation began 3 months after the treatment was initiated. A lipoatrophic defect developed on the thighs and the upper outer arms, resulting from repeated insulin injections at the same site. Regarding lipoatrophic areas, treatment with topical administration of corticosteroids was attempted but without a significant clinical effect. The best prevention from lipoatrophy development is education of patients regarding rotation of insulin injection sites and more frequent needle change.

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Section: Discussionmentioning

confidence: 99%

“…They should be instructed to alternate the injection sites, to observe the skin, and not to use the same needle for a long period of time (up to 12 times). 9,10 In case of lipoatrophy, attempts to treat the affected areas include topical corticosteroid injections. A positive reversal is recorded in some of the treated patients.…”

Section: Discussionmentioning

confidence: 99%

Insulin-induced Lipoatrophy in a Patient on Insulin Analogue Therapy: a Case Report

Yanachkova

Staynova

2020

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“…Injection into lipodystrophied sites, results in an erratic absorption of the drug, leading to glycaemic variability making it difficult to achieve suitable metabolic control. 12 Treatment of insulin induced lipodystrophy include subcutaneous co-administration of corticosteroid with insulin, changing between different insulin preparations, rotation of injection sites, change of needles or syringes/pens, appropriate storage of insulin, changing the mode of insulin delivery, mast cell stabilizing therapy with topical 4% sodium cromolyn has been reported to reverse early and prevent new lipoatrophic lesions, soft tissue augmentation using a variety of permanent and nonpermanent fillers is also an option for cosmetic improvement of localized lipoatrophy. 13 In a study conducted by Hauner et al, and Kashi et al, prevalence of LH was reported to be 3.6% and 14.5% of the diabetic patients, respectively.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of insulin induced lipodystrophy in patients with diabetes mellitus in a tertiary care centre: a cross sectional study

Bezawada¹,

Anuradha²,

Kalra³

2019

Int J Basic Clin Pharmacol

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Background: Diabetes Mellitus is a spectrum of common metabolic disorders whose management mainly lies in treating the patients with oral hypoglycaemic drugs and insulin along with the dietary and lifestyle modifications. Lipodystrophy is the most neglected adverse drug effect caused by injecting insulin. The main objective of this study was to assess the prevalence of lipodystrophy at the insulin injection sites in patients suffering from diabetes mellitus (Type 1 and Type 2).Methods: A cross-sectional study was conducted in the Department of Endocrinology on 250 diabetic patients taking insulin injections based on inclusion and exclusion criteria. The demographic features and anthropometric measurements were noted. Insulin injection sites were examined clinically by inspection and palpation for presence of swelling like lipodystrophy, injection marks and signs of allergy like erythema etc. Lipodystrophy was graded from 0-3 and denoted as lipohypertrophy or lipoatrophy. The results were tabulated and presented accordingly.Results: In this study, out of 250 patients 17 (6.8%) patients presented with insulin induced lipodystrophy. Lipohypertrophy was the most common presentation and only one case presented with lipoatrophy.Conclusions: It can be concluded from the present study that lipodystrophy which is an important adverse effect due to insulin injection needs to be monitored regularly in every patient taking insulin for better control of glucose levels.

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“…Para resolver este problema, en primera instancia, puede ser suficiente cambiar el sitio de la inyección, pero esto no garantiza que no se desarrolle LH posteriormente. Por lo anterior, se recomienda la inspección de los lugares de inyección en cada visita al médico, lo que ayudará a la detección temprana de esta complicación (29,48).…”

Section: Educación Para El Paciente Con Tratamiento Insulínicounclassified

“…A su vez, es necesario crear conciencia de que es un proceso continuo, en el que se debe reevaluar periódicamente la técnica de inyección e inspeccionar las zonas de aplicación de la insulina (42). Hasta donde sabemos, además de la reacción inmune local a los cristales de insulina, el uso frecuente de la misma aguja, la falta de rotación de los puntos de inyección y el uso de los pliegues de la piel, favorecen el desarrollo de LH en los pacientes (48,49). Por lo ante-rior, y reconociendo que la administración de la insulina es a menudo difícil, la prevención es vital y puede lograrse mediante la educación en la enfermedad y sobre las mejores técnicas de inyección desde el momento mismo de su diagnóstico (50).…”

Section: Educación Para El Paciente Con Tratamiento Insulínicounclassified

Lipohipertrofia: conocimiento y educación al tratamiento con insulina en la diabetes mellitus

2019

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Introducción: la diabetes mellitus tipo 1 es una enfermedad crónica que, una vez diagnósticada, genera cambios en el estilo de vida del paciente. Para lograr un tratamiento óptimo y evitar complicaciones posteriores, como lipohipertrofia por el aumento en el uso de la insulina, es de vital importancia que se brinde a los pacientes y el personal médico una adecuada educación, para que adquieran conocimientos y habilidades en la aplicación de la inyección de insulina. La lipohipertrofia se presenta por acumulación de grasa subcutánea en el sitio donde se inyecta constantemente la insulina. Objetivo: describir la lipohipertrofia en pacientes con diabetes mellitus, los conocimientos y educación que debe adquirir con respecto al tema. Metodología: se realizó una revisión de literatura en las bases de datos SciELO, Ovid, Medline, PubMed, ScienceDirect y Elsevier, que permitió identificar 71 artículos, de los cuales 50 cumplían con los criterios y pertinencia de la búsqueda. Resultados: se seleccionó la información más completa y pertinente de las bases de datos, respecto a la lipohipertrofia, conocimiento, educación y tratamiento con insulina en la diabetes Mellitus. Conclusión: esta revisión permitió determinar que la lipohipertrofia, una complicación secundaria del tratamiento con insulina en la diabetes Mellitus; se origina en factores tales como la técnica de aplicación y rotación inadecuadas de los puntos de inyección, el escaso conocimiento de los pacientes acerca del tratamiento y la falta de educación del personal sanitario con respecto al uso de las técnicas de aplicación de la insulina.

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Insulin lipodystrophy and lipohypertrophy

Cited by 21 publications

References 4 publications

Insulin-induced Lipoatrophy in a Patient on Insulin Analogue Therapy: a Case Report

Insulin-induced Lipoatrophy in a Patient on Insulin Analogue Therapy: a Case Report

Prevalence of insulin induced lipodystrophy in patients with diabetes mellitus in a tertiary care centre: a cross sectional study

Lipohipertrofia: conocimiento y educación al tratamiento con insulina en la diabetes mellitus

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