Lumps and Bumps from Insulin Therapy
Here at Medtronic, we get a lot of questions from customers about the lumps and bumps that may appear at injection sites. So, here’s a Q&A on what these lumps are, why they occur and how to prevent them.
What are these lumps and bumps at my injection sites?
Lumps and bumps from insulin are called lipohypertrophy. This is a medical word for a lump under the skin from an accumulation of fat at the site of many insulin injections. Scar tissue may also develop at the sites.
Why does this happen?
This happens due to the action of insulin on the fat cells. Insulin can actually cause fat cells to increase in size. It is generally seen when one uses the same area for insulin injection or infusion. It happens most often in areas that are easiest to inject insulin or place infusion sets—on both sides of the belly button and on the sides of the thighs.
What happens when you have this?
You may notice a thickening of this skin and areas of lumps and bumps. This was more evident with the older preparations of insulin where the skin changes were more evident. The changes may be very subtle with the newer insulin analogs so it is important to actually feel the areas that you use to inject or infuse insulin. You want to firmly stroke the areas in a sweeping motion to feel for any lumps.
Does it affect your glucose control?
Infusing insulin into areas of lipohypertrophy can affect your glucose control. Insulin is not always well-absorbed in these areas. You may find that your glucose control is not what you expect it to be. The more damaged the area is the more likely it is that glucose control will be affected. Sometimes the areas of lipohypertrophy have damaged nerve endings and you don’t feel your infusion set going it at all. This is clearly a sign of a damaged area.
How is it prevented?
Rotate your infusion sites! It is important to use different sites to prevent lipohypertrophy. You might want to use a calendar or body map to be sure that you are rotating you sites frequently. Avoid areas that have lipohypertrohy and allow them to heal before using them for your infusion site.
Editor’s Note: Please click here for information on the “Clock” or “M or W” site rotation methods.
Any other tips?
If you do discover areas of lipohypertrophy and move to new areas to place your infusion set you may need to test your glucose more frequently. Insulin is absorbed differently in different body areas and this may affect your glucose. If you have been using your abdomen (where insulin is absorbed the fastest) and start using your buttocks (where insulin is absorbed more slowly) you may see your glucose values change more slowly as well.
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Comments
Sara
Posted on Tue Jan 17 20:19:01 GMT 2012
This is great! I had been putting my infusion sites on my "love handles" for a while because that was the easist location for me, and for a while, the most predictable. Well, I think I overused those sites because I started to have absorption issues. Now that it is winter and my sleeves are longer, I am having some good luck using the back of my arms.
Robin
Posted on Sat Feb 04 18:02:34 GMT 2012
I have been diabetic for 20+ years and was put on insulin pump therapy in October 2011. I have problems when a site works for the first day then it is as if I have no insulin working after that. I was told to only use my abdomen, so I can't change sites a lot, but, I am running out of sets from changing them so much to try to find a site that works. Any ideas?
Rachel
Posted on Mon Feb 06 04:13:57 GMT 2012
Robin, I have had an insulin pump for almost ten years and would love to know the answer to that. I believe I must now have lipohypertrophy. Two days ago I was trying to insert CGM and took it out because of pain and all the sudden discovering a large lump which has turned into a huge bruise and smaller lump. I go through spots that work for a while and then it is like they become "immune" so to speak. I wish I had an answer because when this happens I tend to get pretty upset.
Karrie
Posted on Fri Feb 10 21:40:00 GMT 2012
@Rachel I’m sorry to hear that. I’ve sent your comment to someone from our HelpLine team who will reach out to you shortly to try to help.
Teresa
Posted on Mon Mar 05 00:19:53 GMT 2012
I can relate to Robin and Rachel. I've been on a CGM since June 2009. I'm having trouble finding insertion sites. My abdomen isn't good for the CGM b/c of lipothypertrophy (I've been on a pump for 25 years) and I'm currently using my hips and upper buttocks for the CGM, but I'm really struggling with finding new places. Any suggestions? Has anyone used the thigh area for the CGM?
Karrie
Posted on Mon Mar 05 20:40:00 GMT 2012
@Teresa the Medtronic sensor is actually only approved for use in the belly area. For infusion sites, there are more approved options (arm, thigh, top of buttocks). You can find more about site rotation and selecting sensor and infusion sites here: http://www.medtronicdiabetes.net/support/insertion-site-management. And if you’re having trouble with lipohypertrophy, I’d definitely check in with your healthcare team. They’ll likely have additional guidance for you.
Kate
Posted on Thu Apr 18 11:41:28 GMT 2013
I do rotate my shots all the time, but it doesn't seem to matter where I give the shots it always leaves a bump and they hurt to touch..
Naomi
Posted on Thu Apr 18 21:58:14 GMT 2013
Kate, I’m sorry to hear that. This sounds like a great question for your healthcare team as they can give you the best advice to meet your individual needs. If you have any questions related to a Medtronic device, let me know and I can connect you with someone to help.
Nicole
Posted on Mon Apr 22 03:11:24 GMT 2013
I've only been using insulin for about a year and I only have this on my legs. However the areas bruise, the lump appears and it itches like crazy. I wonder if it's the type of insulin might also help. Instead of using synthetic insulin or animal based....I actually asked if I was allergic to the brand I was using. I know the body produces it naturally but it's not pure there are additives added to the medication. Could it be a problem like that?
Naomi
Posted on Mon Apr 22 15:50:33 GMT 2013
Nicole, I’m sorry to hear you’re experiencing this. However, I’m not qualified to give medical advice. This is a question best asked to your healthcare team as they can answer questions specific to you and your needs. If you have any questions about a Medtronic device, let me know and I’d be happy to connect you with someone.
Dale
Posted on Wed Apr 24 15:48:37 GMT 2013
Been on insulin since December, 12. Have had no real problems. But, now I have a lunp in my abdomen that has enlarged since noticed about 4 days ago. About the size of a quarter, from, originally about 1 inch long and 1/3 inch wide. Also redness on surface at the site. No pain
Naomi
Posted on Wed Apr 24 20:41:12 GMT 2013
Dale, I’m sorry to hear that. It sounds like you should consult your healthcare team as they can give you the best advice about this. If you have any questions related to a Medtronic device, let me know and I can connect you with someone.
CHARI
Posted on Tue May 21 09:06:52 GMT 2013
I have just started Insulin Injection . Is there an Ointment / Cream which can soften the Skin
Naomi
Posted on Tue May 21 20:44:06 GMT 2013
Hi Chari, I’m not qualified to give any kind of medical advice. I recommend that you ask your healthcare team as they can give you the best advice to meet your individual needs. If you have any questions related to your device, let me know and I can connect you with someone.
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