Endocrine Abstracts

Introduction: Lipohypertrophy (LH) is a chronic complication of diabetes mellitus that caused by frequent s.c. injections of insulin. Nowadays, LH were modified due to good quality modern insulin and expansion their concentration. As a result, some difficulties of diagnosis were appeared.

Design: The aim of this study has been to compare the frequency of insulin induced LH in diabetic patients revealed by ultrasonography of subcutaneous fat with those founded by palpatory method. This study was done on 215 diabetic patients (142 females and 73 males, mean age was 46 years) who had been under the treatment with insulin a mean 10 years. Observation and palpation techniques, as well as ultrasonography of subcutaneous fat were used in assessing LH in these diabetics. Evaluation of subcutaneous fat was made in typical injection sites: paraumbilical and buttocks regions, lateral surfaces of hips and shoulders. All patients injected insulin in physiological regimen.

Results: On the basis of palpation LH were revealed in 66 patients (30.7%), while pathologic areas of subcutaneous fat didn’t discover in 149 subjects (69.3%). Further ultrasonography of injection sites was performed to all patients. LH were revealed in 186 patients (86.5%), including those 66 subjects with palpatory changes. Pathologic areas of subcutaneous fat the most often were occurred in paraumbilical regions – 131 patients (61%). Also LH were found simultaneously in two sites: paraumbilical regions and lateral surface of hips – 32 subjects (15%); paraumbilical regions and lateral surface of shoulders – 24 patients (11%).

Conclusions: LH were modified due to good quality modern insulin and expansion their concentration. As a result, pathologic areas of subcutaneous fat were revealed in 30.7% patients by palpation, while LH were found in 86.5% subjects by ultrasonography. Ultrasonography of subcutaneous fat could be used to diagnose LH in diabetic patients in clinical daily practice.