Sarah Howard
Sarah Howard has worked in the diabetes research field ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Marketing Manager at T1D Exchange.
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Have you developed lipohypertrophy due to repeated injections/infusions of insulin? Lipohypertrophy is a term to describe hardened lumps of body fat just under the skin that resulted from repeated insulin injections/infusion sites. If so, share how you’ve handled lipohypertrophy in the comments! Cancel reply
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I have sites of poor absorption but not sure if they can be officially called this as they don’t seem to be hard.
I am not sure you can do anything about them. I switched to Omnipod which you can put in many different sites. So that helps with absorbing insulin.
@Amanda Barras,
Speak with your diabetic doctor about the possibility of lipodystrophy, ma’am. This is a related condition which results in fat loss from injection sites, though it can also be the result of other medical conditions.
Wow. As of now, the poll reads 1/3 yes, 1/3 no, and 1/3 IDK. I am in the latter, as I realized 5 years ago that I was having a heck of a time piercing my skin, so much so that I would cry from frustration (it would take five pokes or more before I might give up and just eat a salad). I then chose the omnipod and haven’t looked back.
I hunt around for spots that have not been hardened by repeated injections.
Yes in my upper arms when I was a petite and skinny child in the 1960s with T1D. In those days we used glass syringes with stainless steel 1/2 inch long heavy gauge needles. My mother would jab me in the upper arms, it hurt like the dickens, and I developed several hard nodules. I was diagnosed at age 8 in December 1962 and after the initial two months of her jabbing me in the upper arms, I took over giving my own “shots” and started self injecting via site rotation in my thighs for several years.
Eventually the lipohypertrophy in my upper arms resolved and I never injected there again until many years later as an adult on MDI using disposable syringes with very short and fine gauge needle tips. Periodically I would give my tired pin cushion thighs a rest and take a break for a few months or a couple of years and rotate injections in my abdomen or upper arms. Have been using a pump for over 20 years now and rarely use MDI unless I am taking a pump break for a short period of time. Happily, I no longer have lumpy sites.
P.S. I rotate my sites whether on pump or MDI.
Hi Connie, I still have my glass syringe and show it off occasionally. We boiled the needle and syringe every morning and sharpened the needle with a file. I was diagnosed at age 6 in 1963. Life is so different now! Then, my diet was extremely limited as was my exercise. Now, I am very active and eat pretty much as I please. I maintain an A1C in the low 6s (6.2 was my last).
Connie and Beth,
I was diagnosed in Nov 1962, age 10. During the early years I developed lumps and indentations on my upper thighs from my injections. In fact, I was able t o spot other t1 kids in my junior high school based upon the lumps in their upper arms.. (I eventually met up with them and learned that I was correct.)
By the time I reached my twenties, these indentations had more or less disappeared, but I still have remnants of the lumps. I wish I could say that the layers of tissue now deposited on my legs disguises them, but they don’t.
I think the changes in insulin have been responsible for this improvement: the isolation and purification of animal insulins were refined, and then the various human clones were game changers in many ways.
to the 3 sweet ladies,
I started about 70 years ago at age 21 years
I think I only used upper front legs and had some hollows, but dont remember lumps. I was down to 118 lbs from the T1D [skin & bones].. Slowly got up to 143 lbs and used my butt some times.. Found an off brand plastic syring that had an aluminum gizmu that would hold the loaded syringwhile you put it on your butt and fired it into your butt and then pushed the plunger.. That syring is no longer available…. So I started using my tummy area and upper front legs until 2 years ago when I gave the tummy to the G6.. Now I am down to 122 lbs and have been on imuno infusion for 6 months to treat mesothelioma asbestos related lung cancer..
The hard spots are fairly frequent with the pump infusion sets. Especially if I go past 3 days which I try to avoid! I don’t think I ever got one from injections. I try heat and massaging to treat them and they normally go away after a day or so. Once I had a large area that I had to treat with antibiotics.
Upper abdomen just below ribs became hard and lumpy. Stop using that area for pump infusion sites and they softened up enough to use that area occasionally. Still a little bit of a push to get it in.
I have two areas on my lower abdomen from years of MDI. After switching to pump I have had no issues. I just avoid the lumpy areas.
In the early 1950s my parents were not told to rotate the injection sites. In the 1960s I had sunk in places on my inner thighs from so many injections and then I was told to not use that site again. It returned to normal after many years.
I developed lipohypertrophy many years ago from repeatedly injecting in my lower abdomen. At that time I was prescribed 4 daily injections of insulin, which was NOT controlling my diabetes. Control was so poor, even after my diabetologist and/or endocrinologist tried different types and doses of insulin. (It was initially ‘picked up’ by a genitourologist who sent me for scans as he thought that there was a possibility that I may have developed cancer. Results from various scans and x-rays proved this NOT to be the case, so he wrote to my endocrinologist to see what he thought.)
I steered clear of injecting myself in my abdomen and started to use my upper thighs, which meant I needed to shave my legs prior to each injection … hairy legs. lol.
The lipohypertrophy has ‘gone’ but I do still have hardened areas within my abdomen, even though I’ve been using a pump since 1989, which means there’s only one ‘injection’ every week. 😉
Oops! That one ‘injection’ a week is for my CGM Sensor. I do, of course, need to change my infusion set every 2-3 days. 😉
When I was doing 5 shots daily, developed areas that became unusable. Simply moved to other areas and over time the hardening became less pronounced. Now with 2-3 punctures a week process is much better. (Pump and Dexcom). Am also using arms for Dexcom to continue giving my abdomen a break.
Yes, on my belly and my upper buttocks. I used to have lumps on my legs and arms, but they seemed to have gone.
I also have a skin condition, psoriasis, so I get all kinds of lovely marks and bumps. I don’t think anything has lasted, though. Hard to say, since I use a pump
I use a pump and have had issues with insulin absorbtion. It seems I have a lot of them on the side I primarily use for infusion sets. I recently switched to the other side of my abdomen and dropped more than one point on my a1c.
Yes. When it happens, I try to avoid that site until the skin has healed. Not having many site options when using both a pump pod and a GCM is a challenge.
Yes, I developed lipohypertrophy due to taking 5-6 injections a day. My abdomen, thighs, and upper arms are affected. The absorption of insulin was affected and my A1C was rising to a level of 7.9 and higher. I solved the problem by persuading my doctor to allow me to switch to Afrezza. I now only inject the basal insulin and my A1C has been below 7.
No lipohypertrophy that I can see or feel but definitely places of scar tissue and stretch marks that I avoid. Especially on abdomen from years of pump therapy. Now on MDI and use butt for injections at home. Nice rest for abdomen. Also use upper thighs although not much fat on my legs
After 62 years I have skin issues everywhere. I am an avid at rotating every time I change my infusion set. When I was on multiple daily injections, up to 9 per day, I had massive skin hardening. Since on the pump it’s not nearly as bad that’s been 33 years. I take very little insulin my daily basal comes out to 9 units over 24 hours I eat two meals that I count carbs for and try to keep at a minimum of 30-40 per day. Everything is going well. Rotation is key
Definitely some type of tissue damage after 45 years of injecting, pumping and using a CGM. Changing to metal infusion sets seemed to decrease the tissue damage/trauma from my infusion set.
I have areas on my body that have poor absorption. I call that scar tissue interference. I used my upper ab for so many years, and I cannot use that area now. I am using my lower ab and upper legs now. I do not feel hard lumps under my skin, but there is definitely scar tissue, mostly in my upper ab.
Same here
Yes, after many years of U-40 Regular (beef-pork) injections in my upper thighs. That was the only area my pediatrician told me to use. My mom would jab me in the upper arm with what seemed like a 9 ft. needle, so as soon as I could manage to hold both the vial and glass syringe and add the prescribed amount of insulin without air bubbles, I took over my daily injections. Although that was many decades ago, the lipohypertrophy on both upper thighs still remains.
No, but, I did burn all the fat from my arms from old U-40 and u-80 NPH from the 1950’s and 1960’s. Any shots or sites there are now quite painful.
never used arms but had some of that back then on legs so skinny me used my butt to avoid it… noticed the change when the humin insulin came available..
More so with MDI than insulin pump infusion, however, I have had to resort to TruSteel catheters to ensure reliable insulin absorption.
I switched to a tandem pump and thst helps.
I have had Type 1 Diabetes for 50 years. In the last 3 or more years I’m having so many problems placing my tandem pump because of insulin absorption issues. Every 3 days I have to adjust basil and carb ratios because each site absorbs differently. It’s so depressing.
I have two spots on my belly. I avoid those spots for any injections.
Developed it on my abdomen after 26 years of MDI, been on a pump for the last 10 years and track my sites, writing where the new location is and time when I change the set. I can usually go for almost 6 weeks before going back to a specific location and I think that’s I haven’t developed any other problem spots.
I switched to the trusteel infusion sets and that helps. Also have lipoatrophy but it has gotten better over the years of taking better insulin.
To the right and down of my belly button (looking down). About the circumference of a baseball… I just avoid that area. As far as I know, there is nothing I can do to fix/repair that area.
No, but I do have lipoatrophy from the way back times.
No lipohypertrophy for me. I’m with Becky Hertz. I have lipoatrophy… craters of lost fat… the slowest and worst way in the world to lose weight! ;p
Telling us to “rotate” is a proforma answer and offensive. NOT a solution of any value! Akin to telling the asthmatic patient to ~just breathe~… Sorry telling us just rotate is a non answer, pretending otherwise. Just rotate are empty filler words and no substance.
Used to be obvious when I was on Lente as a kid on the back of my arms. Then switched to belly, and my endo told me I was just fat. (I didn’t think so)
After 56 years of T1D (34yrs of injections up to 5 / day), my buttocks have some scar tissue. The description of lipohyertrophy doesn’t match with my scar tissue. I don’t have hard lumps, just areas that feel firmer under the skin. I also have more problem with sunken spots (atrophy) in my ‘favorite’ injection spots. Dealing with it is basically trying to avoid those spots. If a site is not absorbing, I take a hot shower or do moderate exercise to increase blood flow to the area. BGs will plummet though so I have to be cautious. I also started using alternative infusion sites and also have considered a variable angle infusion set, but have not yet tried it.
I started to but then switched to my upper thighs and am able to rotate over a much greater surface area.
I have at times over the past 58 years. I simply avoid using that area until my skin has time to heal.
I stopped using those sites and paid more attention to rotation of available ones.
I used another part of my body for awhile and the lump went away.
I just don’t inject there until the lump is gone and still don’t for awhile. I keep a log book on where I inject myself.
I now avoided the affected area
Avoided the area.
After over 60 years as a T1D using injections, not pumps, I‘ve had no problem with this nor abnormal loss of fat.
No, but my daughter has another form of lipodystrophy, which is called lipoatrophy (localized loss of fat tissue). It is very visible and has made those sites unusable for injections, pump sites and sensors.