{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T05:55:28Z","timestamp":1771480528296,"version":"3.50.1"},"reference-count":28,"publisher":"Walter de Gruyter GmbH","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpem-2020-0556_abs_001_w2aab3b7c43b1b6b1aab1c15b1Aa\">\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Insulin-induced lipodystrophy is of two types, lipohypertrophy and lipoatrophy. Lipodystrophy often leads to worsening of glycemic control in type 1 diabetes mellitus. Our objective was to identify the clinical, immunological, and other factor(s) associated with the development of lipodystrophy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2020-0556_abs_002_w2aab3b7c43b1b6b1aab1c15b2Aa\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this observational cross-sectional hospital-based study, 95 children, adolescents, and young adults with type 1 diabetes mellitus were observed for the development of lipodystrophy. Injection technique, insulin dose, and glycemic parameters were noted. Serum TNF-\u03b1, IL-1\u03b2, and anti-insulin antibody levels were measured. Histopathological examination of the lipodystrophic area was done in a small number of people.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2020-0556_abs_003_w2aab3b7c43b1b6b1aab1c15b3Aa\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among the participants, 45.2% of participants had lipohypertrophy and 4.2% had lipoatrophy exclusively; 3.1% of participants had coexisting lipohypertrophy and lipoatrophy. Improper injection site rotation technique was more common in participants with lipohypertrophy in comparison to those without lipodystrophy. The age of onset of diabetes, duration of insulin use, and the number of times of needle reuse were not significantly different between the lipohypertrophy and nonlipodystrophy groups. Serum TNF-\u03b1, IL-1\u03b2, and anti-insulin antibody levels; HbA<jats:sub>1c<\/jats:sub>; rate of hypoglycemia; and body weight-adjusted dose requirement were higher among the participants with lipohypertrophy. On histopathology, scant, or no inflammatory infiltrate was\u00a0found in lipoatrophic and lipohypertrophic areas, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2020-0556_abs_004_w2aab3b7c43b1b6b1aab1c15b4Aa\">\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Improper insulin injection technique and higher levels of proinflammatory cytokines and anti-insulin antibody are associated with lipodystrophy in type 1 diabetes mellitus. HbA<jats:sub>1c<\/jats:sub> and rate of hypoglycemia are higher in people with lipodystrophy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpem-2020-0556","type":"journal-article","created":{"date-parts":[[2021,3,4]],"date-time":"2021-03-04T19:11:29Z","timestamp":1614885089000},"page":"503-508","source":"Crossref","is-referenced-by-count":11,"title":["Associations of insulin-induced lipodystrophy in children, adolescents, and young adults with type 1 diabetes mellitus using recombinant human insulin: a cross-sectional study"],"prefix":"10.1515","volume":"34","author":[{"given":"Arijit","family":"Singha","sequence":"first","affiliation":[{"name":"Department of Endocrinology & Metabolism , Institute of Post Graduate Medical Education & Research , Kolkata , India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0362-5036","authenticated-orcid":false,"given":"Rana","family":"Bhattacharjee","sequence":"additional","affiliation":[{"name":"Department of Endocrinology & Metabolism , Institute of Post Graduate Medical Education & Research , Kolkata , India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bibhas Saha","family":"Dalal","sequence":"additional","affiliation":[{"name":"Department of Pathology , ESI-PGIMSR &ESIC Medical College , Kolkata , India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dibakar","family":"Biswas","sequence":"additional","affiliation":[{"name":"Department of Endocrinology & Metabolism , Institute of Post Graduate Medical Education & Research , Kolkata , India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Subhadip","family":"Choudhuri","sequence":"additional","affiliation":[{"name":"Microbiology & Immunology , University of Texas Medical Branch , Houston , TX , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Subhankar","family":"Chowdhury","sequence":"additional","affiliation":[{"name":"Department of Endocrinology & Metabolism , Institute of Post Graduate Medical Education & Research , Kolkata , India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2021,3,4]]},"reference":[{"key":"2023040101452975046_j_jpem-2020-0556_ref_001_w2aab3b7c43b1b6b1ab2b1b1Aa","doi-asserted-by":"crossref","unstructured":"Rohlfing, CL, Wiedmeyer, HM, Little, RR, England, JD, Tennill, A, Goldstein, DE. 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