A new study in Diabetic Medicine has found that different types of lipohypertrophy (LH)—a common skin complication caused by repeated insulin injections—can impact how much insulin people with type 1 diabetes (T1DM) need. The research suggests that avoiding injection at affected areas may have a significant reductions in insulin doses, especially in specific LH subtypes. 

Researchers conducted a prospective observational study involving 288 hospitalized patients with type 1 diabetes mellitus (T1DM) who had been living with the condition for at least one year. Using ultrasound, the team assessed the presence and type of LH at the patients' usual injection sites. Based on the results, patients were categorized into four groups: LH-free (LH-0), nodular hyperechoic LH (LH-1), diffuse hyperechoic LH (LH-2), and hypoechoic LH (LH-3). All participants then received insulin through a pump placed away from the LH-affected areas, and doses were gradually adjusted to achieve stable blood sugar levels.

Among the participants, 36% were LH-free, while 64% had some form of LH. After avoiding insulin injections at LH sites, all LH-positive patients required less insulin overall. However, there was a difference in the extent of insulin reduction by LH type. Significant dose reductions were reported in the LH-2 and LH-3 groups, while the LH-1 group had no meaningful change.

The reductions in insulin dose were primarily due to decreased need for bolus (mealtime) insulin. In the LH-2 group, 88% of the dose reduction was from bolus insulin, while the LH-3 group saw a 75% drop in bolus insulin needs.