The prevalence of lipohypertrophy and its associated factors among Saudi patients with type 2 diabetes mellitus

OBJECTIVES: We conducted this study to establish the prevalence and associated risk factors of lipohypertrophy (LH) in patients with type 2 diabetes mellitus (T2DM) who are on insulin therapy in the Kingdom of Saudi Arabia (KSA). METHODS: This multicenter, cross-sectional study was executed at primary care clinics in King Saud University Medical City and Prince Mohammed Bin Abdulaziz Hospital in Riyadh KSA from May 2017 to October 2017. All adult patients over 18 years old with T2DM who had been treated with insulin via either a syringe or pen for at least two years were physically examined for LH. RESULTS: A 39.7% prevalence of LH was found in our study cohort of which as many as 57.5% patients were found to be in LH grade 1, 33.75% grade 2, and 8.75% grade 3. LH was detected in 68.8% patients who used different sites for every injection and in 63.7% (p = 0.182) of patients who had injected more than 60 units per day (p < 0.,0001). Overall logistic regression analysis showed that the patients who used alcohol swabs were 2.6 times more likely to develop LH. Interestingly, the patients who used more than 60 units of insulin per day were 0.362 times more likely to develop LH. CONCLUSIONS: Lipohypertrophy is a complication common among patients with T2DM in KSA. It is incumbent upon healthcare providers to raise awareness about LH and to provide extensive education about correct insulin administration among patients with T2DM on insulin therapy.