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Troubleshooting glycemic variability. Do you consider lipohypertrophy?

lori CANADA

lori
Total Posts: 20
Joined: March 19, 2014

A recent study in Spain(1) showed a 64.4% incidence of lipohypertrophy in a sample size of 430 outpatients living with diabetes on insulin. 49.1% of the patients with lipohypertrophy had reported glycemic variability (defined as fluctuations from 3.3mmol/L to 13.9mmol/L at least three times a week in an unpredictable and unexplained fashion). Do you consider assessing for lipohypertrophy in your patients with glycemic variability? If so, how do you assess? If not, why not? (1) Blanco 2013http://www.ncbi.nlm.nih.gov/pubmed/23886784...

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Posted on April 8, 2014 at 12:45 PM

pozze ONTARIO

Total Posts: 1
Joined: May 9, 2014

Re: Troubleshooting glycemic variability. Do you consider lipohypertrophy?

I just wasn't convinced it was as significant a problem until I started to see it repeatedly. I then started to question was this new or was this new to me? Having recently attended a presentation by KW Strauss, his work depicted information that represented not only the obvious lipohypertrophic presentation – you know the big ‘lumps’ we all see, but also the indiscernible hypertrophy which were only detected through ultrasound. Sometimes we can see it/feel it. Sometimes we cannot. It’s still there and we need to remember to consider it even if we have no obvious proof.

Posted on May 12, 2014 at 10:25 AM

lori CANADA

lori
Total Posts: 20
Joined: March 19, 2014

Re: Troubleshooting glycemic variability. Do you consider lipohypertrophy?

Hi Pozze. Thanks for sharing your experience. I think you are right is it new - or new to me. Dr. Strauss's presentation is amazing and really helps put the idea of why lipohypertrophy occurs together - injection causes trauma - add insulin a growth factor and it is no wonder that we get areas of "fat on steroids" also know as lipohypertrophy.

Your point about the obvious areas is also important - just because you cannot see it does not mean it is not there!

Asking questions about injection technique can lead us to some important information about why glycemic variability is occurring

Thank you for being "FIT"

Posted on May 21, 2014 at 9:09 PM