Endocrine Abstracts

Forum for injection technique (FIT) recommendations for lipohypertrophy (LH) detection influenced clinical examination technique with the aim of improving practice and health outcomes for children and young people (CYP). Interactive LH workshops were developed to influence a change in care provision and facilitate swift integration into clinical practice.

The event was delivered to MDT representatives from the CYP diabetes network. A structured clinical examination was role modelled facilitated by four young male volunteers with diabetes. Two YP managed their diabetes on multiple daily injections (MDI) regime and two were on continuous subcutaneous insulin infusions (CSII). Opportunity to visualise and palpate sites for LH outwith the pressured clinic environment was universally appreciated by all attendee’s. The use of head torches, safe skin marker pens, and application of ultrasound gel in liberal amounts was widely agreed to enhance detection. Attendee’s were encouraged to examine with two fingers at a 30° angle and firm pressure which also facilitated identification. Most were able to distinguish between softer smoother areas and a transition to harder more rubbery skin. Both medical and nursing colleagues reported increased expectation to find LH as well as confidence using an agreed method base don best practice. Although the number of volunteers was small a difference in the shape formation of LH in patients on CSII (more diffuse and uneven) compared to those on MDI (more localised and discreet) was also observed and may have implications for practice. In conclusion health care professionals reflection on practice and agreement of tangible changes in detection of LH has the potential to reduce glycaemic variation ad hypoglycaemia.