Poor glycaemic control caused by insulin induced lipohypertrophy

Abstract

Introduction Good glycaemic control reduces the risk of complications of diabetes.1 Secondary failure of oral hypoglycaemic treatment is common in patients with type 2 diabetes, and thus insulin treatment is often needed to improve glycaemic control. Indeed, in the UK prospective diabetes study 38% of patients with type 2 diabetes needed insulin treatment after 10 years.1 The reasons for poor glycaemic control are many; and despite insulin treatment many patients with diabetes have poor glycaemic control.2 Lipohypertrophy is characterised by a benign “tumour-like” swelling of fatty tissue secondary to subcutaneous insulin injections. We describe two cases in which poor glycaemic control was directly related to insulin induced lipohypertrophy, recognition of which led to major improvements in glycaemic control.