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31 Responses

  1. Melissa Lee
    Melissa Lee March 14, 2013 at 6:02 am | | Reply

    Leaving it alone is my best suggestion, too. For my first ten years, I used only a tiny area on each arm and thigh, with each of my four daily injections in a set location (dinner, right arm, lunch left arm, etc). I developed large lumps there. After I moved to a pump, those lumps disappeared. Took a year or more perhaps. Of course, then I did the same thing to my lower abdomen for 8 years on a pump! It took nearly two years of avoiding my abdomen before I could infuse there again.

  2. Melissa
    Melissa March 14, 2013 at 6:17 am | | Reply

    Hi Amy! I feel you – thanks for raising the point that adding geometry to all the algebra we do every day makes diabetes even more complicated. I definitely felt like a lazy patient when I worked on the infusion site guidelines for AADE a few years ago.

    On the point re leaving a spot free of Skin Tac, the other week at the ATTD Bruce Buckingham showed some data from the Dexcom G4 pediatric study that indicated no problems from either Mastisol or Skin Tac being applied to the skin before sensor insertion, sort of poking a hole in the doughnut advice (so to speak). Just thought you might like to know that. Also, at ATTD Roche shared some new info on DiaPort, which has been shown to be a good thing for people with severe lipohypertrophy. Lesley Jordan has posted about hers here: http://www.insulin-pumpers.org.uk/diaport/

  3. Robin
    Robin March 14, 2013 at 6:57 am | | Reply

    Oh dear! I was lumpy and thick before I ever started injecting insulin – I hope I can recognize lipohypertrophy when it rears it’s lumpy head. Honestly though, it’s helpful to hear other’s frustration about life as a pincushion. Organizing my Dexcom and my OmniPod sites and waiting for skin to heal: just one more challenge from the gift that keeps on giving.

    But kudos to Gary Scheiner, who gave me clear instructions for rotating sites both when I was on MDI and now that I’m pumping.

  4. Cecile Bell
    Cecile Bell March 14, 2013 at 6:58 am | | Reply

    I feel for you , no pun intended. Did you ever hear about the non invasive glucowatch that got shelved so that all the blood sucking test strip manufacturers could keep on the draw. Thank you for publisizing the pain that you deal with diabetes. The world need to be aware! My son has type 1 for over 25 years. Stay strong and Bless your efforts.

    1. K
      K May 8, 2013 at 4:15 pm | | Reply

      Cecile, a friend of mine was in a trial for the Glucowatches and they HURT every time that they zapped you to test your BG, and left burn welts.

  5. Denise
    Denise March 14, 2013 at 7:03 am | | Reply

    Kerri at SUM uses her thigh for her dex and my 10 yr old always liked her arms for her pod. Start trying arms and legs. BTW, your tummy looks awesome.

  6. Mike Ratrie
    Mike Ratrie March 14, 2013 at 7:42 am | | Reply

    Remember the Macarena with the do this with your right and then with your left?

    I do the Infusion Set Macarena every 3 days (I wanted to call it iMac, but that’s been taken…)

    Lower right side of belly
    Lower left side of belly
    Lower right side of back
    Lower left side of back
    Right buttocks (as far back as I can reach)
    Left Buttocks

    Then, I go back to the belly, but much higher, or maybe in the middle area, trying to keep at least 2 inches from the first spot I used. This gives me about 2 weeks before I get back to the same general body area.

    While this works pretty well, I do have some lipohypertrophic areas, especially on my buttocks and lower belly, so I am trying to expand the areas I go to. Also, not on CGM or the Pod, so I have more real estate to work with. (Lipohypertrophic areas are one of the reasons why I have been holding off on a CGM.)

  7. June S.
    June S. March 14, 2013 at 8:40 am | | Reply

    Great post! Thanks! I also have what I believe is called lipoatrophy – dent marks caused by injections of insulin repeatedly so that my skin is sunken in and is useless for infusion sites. These are located in certain places on my abdomen, and also on my thighs. Wish someone would devise a way for us Type I’s to grown new fatty tissue under our skin!

  8. MikeH
    MikeH March 14, 2013 at 11:32 am | | Reply

    Yes, I have that lipoatrophy mostly on my abdomen site areas… not the best site rotator as I could be, so that’s largely to blame. Although, I just heard recently someone say that they experienced this and switched insulin, and that made all the difference – may have to try that myself! Usually, I just avoid that site for a brief period (maybe a few site change cycles) and it mostly clears up and returns to normal. I did use the Roche temp tattoos up until taking a pump hiatus a year or so ago, and overall I think they’re a great creative idea that I’m sorry to hear went away.

  9. Denise
    Denise March 14, 2013 at 12:16 pm | | Reply

    I just started a thread on CWD to post pics of different site areas so maybe in a few days we’ll have a nice collection. DD only likes tummy sites for pump sites and sensor and only liked arms for pods. I think it might help her, age 10, to see other people’s sites on different body parts.

  10. Janice
    Janice March 14, 2013 at 4:02 pm | | Reply

    Skin tac is great to help with the adhesion, Silesse and Cavilon are great skin barriers so you do not get the rash.
    Have to order them on line, Silesse is a bit cheaper.
    Good luck

  11. Denise
    Denise March 15, 2013 at 7:17 am | | Reply

    Sure, here’s the link to the thread.
    http://forums.childrenwithdiabetes.com/showthread.php?t=72794
    the site is childrenwithdiabetes

  12. Richard
    Richard March 16, 2013 at 4:36 pm | | Reply

    Over here the term lipodystrofia is used alot more, it is a term that refers to an uneven spreading of fat storage in the body, either less or more. It seems to me like it’s a term that encompasses both lipoatrophy and lipohypertrophy. And consisdering cause and solution are largely the same, that might be why they use it.

    First few years I had Diabetes every box of needles I got had a leaflet warning about lipodystrofia, they made great bookmarkers. Last few months they haven’t been in the boxes however, instead theres a leaflet advertizing their other needles. Which does not seem an improvement to me.

    I inject using flexpens, but you’re still suceptible. I used to have this go-to injection site for when I shot in public, like lunch at work. It was this convenient location where I only needed to lift my shirt a little, and not move alot. Leaving that site alone for a few weeks solved it.

    My endo and diabetes nurse always check my stomach for lypodistrophia as well during our appointments, supposedly they notice the difference easier as I see my stomach every day so the gradual change will be less obvious to me. I always assumed this was standard.

  13. John
    John March 17, 2013 at 5:26 pm | | Reply

    There have been some reports and studies of using Verapamil cream to help users with lipohypotrophy but its expensive and usually not covered off label…

    Theres also some research by Echo Theraputics/Sonosite in using Sonoprep and its replacement to help perforate areas with lipohypotrophy issues as a prep for infusion sites… (in addition to their patch CGMS)

    Think theres a reason to consider microneedle arrays for infusion sets as well as other technologies to spread insulin out over a larger area to reduce these kinds of issues…

    Ideally wed skip the whole subq thing and go with Diaport if they can get the kinks/clogging issue resolved and put through the FDA again…

    -J

  14. Friday 5: Diabetes Must-Reads
    Friday 5: Diabetes Must-Reads March 22, 2013 at 5:01 am |

    [...] • What is Lipohypertrophy? [...]

  15. Amy - Diabetes x 2
    Amy - Diabetes x 2 March 22, 2013 at 8:15 am | | Reply

    I worry about this with my daughter. She doesn’t have enough fat on her stomach or legs for injections, so we use the back of her arms for Novolog and her buttocks for Lantus. So far so good, but it would be nice if she would get a little fat on her body for injections. I have plenty she could have! LOL.

  16. Karl Fenn
    Karl Fenn March 28, 2013 at 11:20 pm | | Reply

    I know about this condition I have seen it in other diabetics, the lumps can get quite large, it is important that you do not inject in the same place, and rotate injection sites, if you notice
    any lumps stop injecting in that area, they normally go away after a while I have had one small one, I have heard different
    people say, that altering injection sites can alter the effectiveness of insullin, I did my own research and it seems to
    work the same in any site in the stomach area, some people
    due inject in legs and bottom area, but personally I do not do this, I have
    had any problems since using a rotating method on the stomach. The diagram is good I will try this.

  17. Tartoos: Reducing Complications from Daily Injections

    [...] you’re tired of scar-tissue build up, irritation, and lipohypertrophy from daily insulin injections in life with diabetes, (or you’re the parent of a newly [...]

  18. Tartoos: Reduce Complications from Daily Injections

    [...] you’re tired of scar-tissue build up, irritation, and lipohypertrophy from daily insulin injections in life with diabetes, (or you’re the parent of a newly [...]

  19. Danielle
    Danielle February 18, 2014 at 1:48 pm | | Reply

    I am really upset I have been a type 1 diabetic for 10 years and only ever injected in my stomach, now I look 3 months pregnant I’m not I’m a size 10-12 if I completely avoid my belly will this improve or what else can I do I’m only 28 and my confidence is at its lowest please help thanku

    1. Anna
      Anna June 3, 2014 at 1:05 am | | Reply

      Danielle, it will improve over time. Give your stomach a long vacation, half a year or a year? It will get a lot better. Don’t think about it, you are gorgeous. Celebrate instead your 10 year anniversary whit diabetes, if you have only one diabetes related problem after ten years, you have done great! Had some lumps on my legs, now they have vanished.

  20. Corey Mondello
    Corey Mondello April 9, 2014 at 6:01 am | | Reply

    I’m not a diabetic but I do use needles made for insulin injection to administer lidocaine into non-cancerous lipoma. The areas ended up hardened and raised so I searched around and I found this website, along with a few others. U do not know what insulin in mixed with prior to being bottled, so I don’t know if this will be if any help. From what I have read, sterile water injected can cause more of these skin issues than if saline is used. I have not tried comparing myself, because I use both a different times in no specific order when mixing the liquid with the powder lidocaine prior to injection. But I will. I notice when injecting the same area over and over and getting the “bumps”, the fluid actually does not get absorbed as easily, having to push harder and then many times, the fluid bounces right out, so I quickly toss a alcohol swab on the area with very little pressure to let it absorb, pushing firmly just causes more leakage. I am assuming if this was insulin, the same thing would be happening and the injector may not realize they are it getting the proper dose, causing all sorts of problems. So far, leaving the area alone and finding somewhere else to inject seems to be the most popular suggestion. Unfortunately, for me, a lipoma is only so big, it does not leave me many options when it comes to surface area to inject. One more suggestion, related because of symptom not medical reasons, looking online for information about anything that may lead to injection site issues, like IV drug users, dialysis, these are the same in the way that there are multiple injections where skin issues could arise. NIH.gov published thousands of studies and research covering centuries if all kinds of medical and research related issues. It’s worth a look also.

  21. Anna
    Anna June 3, 2014 at 12:50 am | | Reply

    The importance of rotating sites is clear, and giving the area some vacation is the only thing that really works. I learned the hard way, that it is also very important to have a new needle for every injection… Same thing whit my fingers. I wish i had done it properly before, my glucose balance went slowly to hell as i got the scar tissue problem. Sometimes the insulin was only delayed or just less effective, sometimes it did not work at all.

    My diabetes nurse also instructed me to try different lengths ans different manufacturers needles, they use different coating stuff on the needles. If you are allergic to the coating agent you can more easily get problems whit the injection sites. Sometimes changing to a different type of insulin solves the problem.

    I’m happy whit my new 4 mm needles, the old ones where 8 mm. I tried the 5 and 6 mm ones as well.

    I heard of some diabetics ho use anti cellulite lotion on their problem areas, logic being it increases the blood circulation and the helps the renewing the cells. Haven’t tried it jet.

  22. Bettina
    Bettina June 23, 2014 at 3:40 pm | | Reply

    Maybe someone can help or guide me to some studies that have been done regarding liposuction to remove lipohypertrophy.
    I have been a Diabetic for 26 years and have two very large affected areas on my upper thighs. I am extremely self conscious about it.
    My only solution to this problem is liposuction. I have seen three plastic surgeons, two said the risk of infection after surgery is to high and one said the benefits out way the risks.
    Has anyone had it removed though liposuction? There is very limited info or testimonials on the Webb regarding people who actually had the surgery done.
    Any advise or help is appreciated.

  23. kml
    kml June 24, 2014 at 12:14 pm | | Reply

    Hey there,
    I had the same problem periumbilical on my tummy. Got a liposuction and Im more than happy that I did it. Looks perfrct now.

  24. Lucinda
    Lucinda July 12, 2014 at 9:18 am | | Reply

    I have been insulin dependent for 56+ years; I have been on a pump for 6 years. After injecting for 50 years along with rotating sites my upper thigh areas are disgusting. Lipohypertrophy to the max–have not used upper thigh area for 6 years but no change in the fatty area—it does not go away contrary to what so many say. I hate it—hard to shop for clothes. Has anyone tried Coolscupting or Vanquish procedures?

  25. Carol Hoffnagle
    Carol Hoffnagle August 22, 2014 at 11:38 am | | Reply

    I am trying to gather all the information I can about Lipohypertrophy. I would particularly like to hear from Type I’s for 25 years or more. Would like to know what problems you have and how long you have been taking shots and/or using a pump.
    I personally am tired of reading that this is our own fault for not rotating our sites correctly, especially since the scientific community says that using arms and legs greatly changes the absorption rate.
    I have had Type I for 31+ years, did 4 shots a day for first 10 years then switched to a pump. I have never had an infection and have no complications, other than a permanent fat deposit in my lower abdomen.
    Would like to hear from other people with similar problem. And please I do not need any rotation site maps. Thanks

  26. Chrissy
    Chrissy October 31, 2014 at 6:15 am | | Reply

    I just found this site googling this very issue. I’ve been a Type 1 for 47 yrs. I am now on an Insulin Pump and have been for over 10 yrs. Before that injections of course. Injections or pump I still get the lumps. I do rotate and still get them. I hate them! I really think for me there is nothing I can do about it. I can’t wear my shirts tucked in because my stomach looks big. I’m of average size so this is annoying. I’m so glad I found this place. I plan on looking around and getting to know this site.

  27. Chrissy
    Chrissy October 31, 2014 at 6:17 am | | Reply

    Oh and hi Carol H! :) Another Veteran here….

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