February 12, 2016

The Problems of Hypertrophy

People using multiple daily injections of insulin often develop hypertrophy. Many people are not aware of hypertrophy. This is the enlargement of the areas that has received too many insulin injections. This enlargement is often the result of scar tissue, which causes insulin to pool in this area, and this can increase the enlargement and the scar tissue can trap the insulin and prevent it from getting into the blood stream.

This means that they often have serious blood glucose issues and are difficult to manage. To avoid this problem, many people are not taught about the areas that are useful and can be used to inject insulin. See the diagram below from BD Diabetes.

Rotating among these sites may reduce the risk of lypodystrophy, lumps of fat that develop under the skin from injecting in the same spot repeatedly. Lypodystrophy is not found in any medical dictionary I have, but the BD website uses the term.

For most of us, the stomach area works the best and the area on the arms is second best. The biggest problem many people using insulin is injecting the fast acting insulin in an area too close the long acting insulin. If you want an episode of hypoglycemia (low blood glucose below 70 mg/dl), this is how you do it. I don't recommend this, as it is dangerous and unsafe. This is the reason I use a different area for long acting insulin than I am using for fast acting insulin.

Please understand the hypertrophy is serious and can upset the best management plan. Do not inject insulin in the same spot day after day to prevent this and rotate in the selected areas. I use the different areas on a regular basis and after twelve years and four months, I have a few areas of hypertrophy. I also realize that at my age, the areas of hypertrophy may not heal as quickly so I have to be very careful.

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