Insulin-induced skin lipohypertrophies: A neglected cause of hypoglycemia in dialysed individuals with diabetes

Background Diabetes mellitus (DM) is the leading cause of end-stage renal disease and 50% of dialysis patients are insulin-treated. Aim to search for unexplained hypoglycemia (HYPO). Methods identify a possible cause of HYPO due to altered insulin absorption. Results insulin injected into subcutaneous lipo-hypertrophy (LH) nodules leads to unpredictable HYPOS. Conclusion looking for LH systematically and training patients to the best injection technique are new challenges for nephrologists to reduce HYPO and emergency hospitalization rates, thus sparing healthcare resources and improving the quality of life of insulin-treated dialysis patients.