Prevention of lipohypertrophy.

Lipohypertrophy is an important insulin injection site reaction, which has clinically significant sequelae, including a greater risk of glycaemic variability and higher insulin dose requirement. This article describes the prevention of lipohypertrophy, using the concept of levels of prevention. It enumerates methods of primordial, primary, secondary, tertiary and quaternary prevention of lipohypertrophy. Focus on patient education, site rotation, avoidance of needle reuse, and dose titration when shifting from injection in lipohypertrophic lesions to normal subcutaneous tissue, helps minimize the development and impact of lipohypertrophy.