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Nodules of fibrocollagenous scar tissue induced by subcutaneous insulin injections: a cause of poor diabetic control

University Department of Diabetes and Endocrinology, University Hospital Aintree, Liverpool, UK

Correspondence to:
Correspondence to:
Mrs Maureen Wallymahmed
Diabetes Centre, University Hospital Aintree, Rice Lane, Liverpool L91AE, UK; maureen.wallymahmed{at}aht.nwest.nhs.uk

A 46 year old man with longstanding type 1 diabetes developed major weight loss and marked deterioration in diabetic control. He had been persistently injecting insulin into areas of abdominal lipohypertrophy within which hard collagenised fibrous tissue nodules had developed. Injecting insulin at different sites dramatically improved blood glucose control. Fibrocollagenous nodules induced by insulin injections have not been previously described. Examination of a further 73 type 1 patients revealed lipohypertrophy in 44% and hard subcutaneous nodules on two.

Keywords: diabetes mellitus; fibrocollagenous scar tissue; lipohypertrophy; injection sites