Insulin Absorption from Lipodystrophic Areas: A (Neglected) Source of Trouble for Insulin Therapy?
Open Access
- 1 May 2010
- journal article
- review article
- Published by SAGE Publications in Journal of Diabetes Science and Technology
- Vol. 4 (3), 750-753
- https://doi.org/10.1177/193229681000400332
Abstract
The experienced clinical diabetologist first checks the skin at the area where the patient usually injects his insulin when he sees widely fluctuating blood glucose levels in the diary of the patient. He knows that insulin absorption from skin with lipodystrophic changes is irregular. However, our scientific knowledge about why this is the case is very limited. Most probably, the number of blood vessels near the insulin depot in the subcutaneous tissue varies depending on the nature of the lipodystrophic changes, or the structural changes in this tissue hamper the diffusion of insulin. Not only is our knowledge about the number of patients who exhibit such changes very limited, but also our understanding why such changes show up in certain patients and not in others is minimal. More practically important, we also have few quantitative studies investigating the impact of this diabetes-related complication on insulin absorption/insulin action; however, it is not difficult to run such studies in practice. Nevertheless, it is impressive to see how often metabolic control improves considerably once the patients apply the insulin into other skin areas.Keywords
This publication has 19 references indexed in Scilit:
- Lipodystrophy Reactions to InsulinAmerican Journal of Clinical Dermatology, 2007
- Nodules of fibrocollagenous scar tissue induced by subcutaneous insulin injections: a cause of poor diabetic controlHeart, 2004
- Poor glycaemic control caused by insulin induced lipohypertrophyBMJ, 2003
- A New Case Of Lipoatrophy With Lispro Insulin In Insulin Pump TherapyDiabetes Care, 2003
- A pan‐European epidemiologic study of insulin injection technique in patients with diabetesPractical Diabetes International, 2002
- Insulin antibodies are associated with lipoatrophy but also with lipohypertrophy in children and adolescents with type 1 diabetesExperimental and Clinical Endocrinology & Diabetes, 2001
- Lipoatrophy Associated With Lispro Insulin in Insulin Pump TherapyDiabetes Care, 2001
- Insulin-induced Lipohypertrophy Treated by LiposuctionAnnals of Plastic Surgery, 1996
- Morphology of Palpably Abnormal Injection Sites and Effects on Absorption of Isophane(NPH) InsulinDiabetic Medicine, 1990
- Clinical Factors Influencing the Absorption of125I-NPH Insulin in Diabetic PatientsHormone and Metabolic Research, 1983