{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T13:18:40Z","timestamp":1791897520618,"version":"4.3.4"},"reference-count":24,"publisher":"American Diabetes Association","issue":"9","license":[{"start":{"date-parts":[[2016,8,23]],"date-time":"2016-08-23T00:00:00Z","timestamp":1471910400000},"content-version":"vor","delay-in-days":41,"URL":"http:\/\/diabetesjournals.org\/site\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2016,9,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>Lipohypertrophy (LHT) is common in insulin-treated patients but its exact impact on insulin absorption and action is unclear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>In this crossover study, 13 patients with type 1 diabetes received subcutaneous abdominal injections of 0.15 units\/kg insulin lispro into LHT (confirmed by examination and ultrasound) and normal adipose tissue (NAT). On one day, a euglycemic clamp was performed with two injections each into LHT and NAT, and on another day one injection per region was given before a standardized mixed meal (75 g carbohydrates), all in randomized order.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Compared with NAT, LHT reduced insulin absorption (mean area under the insulin concentration curve [AUCINS0\u20134h] 131 vs. 165 h * mU\/L [LHT vs. NAT]; Cmax 61 vs. 79 mU\/L, P &amp;lt; 0.02, respectively) and effect (areas under glucose infusion rate [GIR] curves [AUCGIR0\u20134h 625 vs. 775 mg\/kg, P &amp;lt; 0.05]) but increased intrasubject variability ([coefficient of variation] AUCINS0\u20134h 52 vs. 11%, Cmax 55 vs. 15%, AUCGIR0\u20134h 57 vs. 23%, all P &amp;lt; 0.01). Postprandial blood glucose (BG) concentrations were \u226526% higher with LHT (AUCBG0\u20135h 731 vs. 513 mg * h\/dL, BGmax 199 vs. 157 mg\/dL, 2-h BG 150 vs. 104 mg\/dL, 5-h BG 145 vs. 81 mg\/dL, all P &amp;lt; 0.05) and maximum concentrations occurred later. Hypoglycemia (BG \u226450 mg\/dL) occurred numerically less frequently with LHT injection (two vs. six patients), whereas profound hyperglycemia (BG \u2265300 mg\/dL) only occurred with LHT injection (two patients). Tmax-INS did not differ between LHT and NAT in either study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Insulin absorption and action are blunted and considerably more variable with LHT injection, leading to profound deterioration in postprandial glucose control.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc16-0610","type":"journal-article","created":{"date-parts":[[2016,7,14]],"date-time":"2016-07-14T06:36:52Z","timestamp":1468478212000},"page":"1486-1492","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":150,"title":["Insulin Injection Into Lipohypertrophic Tissue: Blunted and More Variable Insulin Absorption and Action and Impaired Postprandial Glucose Control"],"prefix":"10.2337","volume":"39","author":[{"given":"Susanne","family":"Famulla","sequence":"first","affiliation":[{"name":"Profil, Neuss, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"H\u00f6velmann","sequence":"additional","affiliation":[{"name":"Profil, Neuss, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annelie","family":"Fischer","sequence":"additional","affiliation":[{"name":"Profil, Neuss, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Veit","family":"Coester","sequence":"additional","affiliation":[{"name":"Profil, Neuss, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidia","family":"Hermanski","sequence":"additional","affiliation":[{"name":"Profil, Neuss, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Kaltheuner","sequence":"additional","affiliation":[{"name":"Gemeinschaftspraxis Kaltheuner, Leverkusen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Kaltheuner","sequence":"additional","affiliation":[{"name":"Gemeinschaftspraxis Kaltheuner, Leverkusen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lutz","family":"Heinemann","sequence":"additional","affiliation":[{"name":"Profil, Neuss, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Heise","sequence":"additional","affiliation":[{"name":"Profil, Neuss, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Hirsch","sequence":"additional","affiliation":[{"name":"Becton, Dickinson and Company Diabetes Care, Franklin Lakes, NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2016,7,13]]},"reference":[{"key":"2022031301541305400_B1","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1177\/193229681000400332","article-title":"Insulin absorption from lipodystrophic areas: a (neglected) source of trouble for insulin therapy?","volume":"4","author":"Heinemann","year":"2010","journal-title":"J Diabetes Sci Technol"},{"key":"2022031301541305400_B2","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1055\/s-0029-1211431","article-title":"Prevalence of lipohypertrophy in insulin-treated diabetic patients and predisposing factors","volume":"104","author":"Hauner","year":"1996","journal-title":"Exp Clin Endocrinol Diabetes"},{"key":"2022031301541305400_B3","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1177\/004947559602600406","article-title":"Systematic inspection of insulin injection sites for local complications related to incorrect injection technique","volume":"26","author":"Seyoum","year":"1996","journal-title":"Trop Doct"},{"key":"2022031301541305400_B4","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.diabet.2013.05.006","article-title":"Prevalence and risk factors of lipohypertrophy in insulin-injecting patients with diabetes","volume":"39","author":"Blanco","year":"2013","journal-title":"Diabetes Metab"},{"key":"2022031301541305400_B5","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.diabres.2006.12.023","article-title":"Incidence of lipohypertrophy in diabetic patients and a study of influencing factors","volume":"77","author":"Vardar","year":"2007","journal-title":"Diabetes Res Clin Pract"},{"key":"2022031301541305400_B6","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1136\/bmj.327.7411.383","article-title":"Poor glycaemic control caused by insulin induced lipohypertrophy","volume":"327","author":"Chowdhury","year":"2003","journal-title":"BMJ"},{"key":"2022031301541305400_B7","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1111\/j.1463-1326.2008.00972.x","article-title":"Lipohypertrophy: does it matter in daily life? 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