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2023

Lipodystrophies from Insulin Injection: An Update of the Italian Consensus Statement of AMD-OSDI Study Group on Injection Technique

by Sandro Gentile 1,2,*ORCID, Ersilia Satta 1, Giuseppina Guarino 1,2 and Felice Strollo 3 ORCID on behalf of the AMD-OSDI Study Group on Injection Technique

Abstract

The causes and metabolic consequences of lipohypertrophy (LH) from incorrect insulin injection techniques have been well-known for a long time and are the subject of countless publications. However, only some researchers propose structured research modalities for LH and programs to teach patients how to prevent them and minimize their effects, thus contributing to complete rehabilitation. Experts and scientific societies have produced consensus documents and recommendations to spread the culture of LH and its complications among clinicians. However, they should go deeper into LH detection methods. This short article analyzes the recent literature on the best way to explore and find more or less evident LH lesions by using a structured and validated clinical methodology to benefit the many clinicians without access to technological equipment such as ultrasonography. This text also aims to bring awareness that since the last published recommendations on injection techniques, new needles for insulin injection, more technologically advanced and suitable for specific populations, have come to market but still need a thorough evaluation.

1 Nefrocenter Research, 84013 Cava dè Tirreni, Italy
2 Department of Internal Medicine, Campania University “Luigi Vanvitelli”, 80138 Naples, Italy
3 Endocrinology and Diabetes Department, IRCCS, San Raffaele Pisana, 00163 Rome, Italy

*Author to whom correspondence should be addressed.
Diabetology 2023, 4(1), 119-127; https://doi.org/10.3390/diabetology4010013

Insulin-induced lipohypertrophy and factors affecting it in children and adolescents with type 1 diabetes mellitus: Review of the literature from the past 12 years: An appraisal and extension to adult subjects

 Felice Strollo 1, Ersilia Satta 2, Luisa Borgia 4 and Sandro Gentile 2, 3, * 

1 Department of Endocrinology and Diabetes, IRCCS San Raffaele Pisana, Via Val Cannuta, 247, I-00166, Italy.
2 Research Department of Nefrocenter Research, Via XXV Lulio 160, Cava de Tirreni, I-84013 (Salerno), Italy.
3 Department of Internal Medicine, Luigi Vanvitelli University of Campania, Via Pansini, 5 – I-80131 Naples, Italy.
4 Department of Life and Environmental Sciences, Marche Polytechnic University, Piazza Roma,22 I-60121 Ancon, Italy.

 

Abstract 

Our research group has dealt with injection-induced lip hypertrophy (IILH) in insulin-treated subjects for over a decade, focusing on causes and consequences, education, prevention and treatment, comorbidities, and related complications. Stimulated by an excellent Review that recently appeared on the pages of this Journal, we want to contribute insight into IILH. This brief Commentary underlines some key concepts on how to identify, prevent and cure them, pointing out salient aspects derived from our research to provide the scientific community with an as complete as possible overview of evidence-based knowledge and highlight the need for further experimental insights. 

Keywords: Diabetes mellitus; Insulin injection; Injection technique; Lipodystrophy; Lipohypertrophy 

World Journal of Advanced Research and Reviews, 2023, 17(01), 596–604 Article DOI: https://doi.org/10.30574/wjarr.2023.17.1.0074