Prevalence of lipohypertrophy and associated risk factors in insulin-treated patients with type 2 diabetes mellitus.
BACKGROUND
Secondary failure of oral hypoglycemic agents is common in patients with type 2 diabetes mellitus (T2DM); thus, patients often need insulin therapy. The most common complication of insulin treatment is lipohypertrophy (LH).


OBJECTIVE
This study was conducted to estimate the prevalence of LH among insulin-treated patients with Patients with T2DM, to identify the risk factors for the development of LH, and to examine the association between LH and glycemic control.


METHODS
A total of 1090 patients with T2DM aged 20 to 89 years, who attended the diabetes clinics at the National Center for Diabetes, Endocrinology, and Genetics (NCDEG, Amman, Jordan) between October 2011 and January 2012, were enrolled. The presence of LH was examined by inspection and palpation of insulin injection sites at the time of the visit as relevant clinical and laboratory data were obtained. The LH was defined as a local tumor-like swelling of subcutaneous fatty tissue at the site of repeated insulin injections.


RESULTS
The overall prevalence of LH was 37.3% (27.4% grade 1, 9.7% grade 2, and 0.2% grade 3). The LH was significantly associated with the duration of diabetes, needle length, duration of insulin therapy, lack of systematic rotation of insulin injection sites, and poor glycemic control.


CONCLUSIONS
The LH is a common problem in insulin-treated Jordanian patients with T2DM. More efforts are needed to educate patients and health workers on simple interventions such as using shorter needles and frequent rotation of the insulin injection sites to avoid LH and improve glycemic control.
Prince Sultan Military Medical, Riyadh, Saudi Arabia.
Mo'men
M
Al Ajlouni
The National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan.
Mousa
M
Abujbara
Department of Community Medicine and Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Anwar
A
Batieha
The National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan.
Kamel
K
Ajlouni
Diabetes mellitus; Insulin; Lipodystrophy