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.

Objective: 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.

Conclusions: 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.