AccScience Publishing / GHES / Volume 2 / Issue 2 / DOI: 10.36922/ghes.2424

Treatment of insulin-induced skin lipohypertrophy: Costs and sustainability of liposuction and education

Sandro Gentile1,2* Giuseppina Guarino1,2 Ersilia Satta2 Felice Strollo3
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1 Department of Internal Medicine, Campania University “Luigi Vanvitelli”, Naples, Italy
2 Department of Nefrocenter Research Network, Torre del Greco, Naples, Italy
3 Department of Endocrinology and Diabetes, IRCCS, San Raffaele Pisana, Rome, Italy
Submitted: 13 December 2023 | Accepted: 27 February 2024 | Published: 20 May 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( )

In the last decade, numerous studies concerning insulin-induced skin lipohypertrophy (LH) were published, mainly addressing epidemiological aspects or presenting case series without placing a focus on LH treatment, among which only a small series (34 cases) has recommended liposuction as LH treatment, albeit not in adherence with the latest American Diabetes Association guidelines. The cost of liposuction, which constitutes a huge financial burden to patients rather than insurance companies or the National Health System (NHS), varies within the range of 1000 – 8000 € with the technique used and the extent and texture of altered skin areas. Primary and secondary prevention through structured educational activities on correct injection techniques with periodic reminders seems to be the only genuinely effective large-scale solution against LH at a much lower, fully NHS-reimbursed cost at 60 € for two annual five-session cycles. However, more research findings, from the angle of esthetic medicine, in support of liposuction as a viable therapeutic solution for LH patients are warranted.

Insulin-induced skin lipohypertrophy

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Conflict of interest
The authors declare no conflicts of interest.
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