Prevalence of lipohypertrophy in insulin‐treated diabetes patients: A systematic review and meta‐analysis

AIMS/INTRODUCTION: Insulin‐treated diabetes patients are at high risk for lipohypertrophy (LH), but this clinical problem has been overlooked by some medical professionals. In addition, studies differed from each other significantly in regard to the prevalence of LH. The present systematic review aimed to determine pooled prevalence levels of LH among insulin‐injecting diabetes patients. MATERIALS AND METHODS: Four electronic databases (PubMed, EMBASE, The Cochrane Library and Scopus) were searched for eligible studies from their inception until April 2017, and reference lists were searched manually to identify additional studies. Studies containing data on LH in patients with diabetes mellitus were included. Meta‐analysis was carried out with a random effects model. RESULTS: A total of 26 studies with a total of 12,493 participants met the inclusion criteria. Meta‐analysis showed that the pooled prevalence of LH was 38% (95% confidence interval [CI] 29–46%, I (2) = 99.1%). The main influence on LH was the type of diabetes mellitus. The pooled prevalence of LH among patients with type 2 diabetes mellitus was higher than patients with type 1 diabetes mellitus (49%, 95% CI 23–74% vs 34%, 95% CI 19–49%). The pooled prevalence of LH of studies involving a mixed type of diabetes mellitus was 37% (95% CI 25–48%, I (2) = 98.3%). CONCLUSION: The prevalence of LH was high in insulin‐treated diabetes patients. It showed that diabetes nurses should screen for LH regularly in their patients, and teach them how to prevent LH in their daily management of diabetes mellitus.