Covered in scar tissue (lipohypertrophy) from injections, but I don't have enough fat to rotate enough to prevent it! #Help

So I saw this article on scar tissue from multiple injections in one place. Turns out it’s actually a little different from scar tissue and is called lipohypertrophy:

Anyways, I’m 22 and have had type one diabetes for 17 years. Since puberty I have not had a whole lot of fat no matter what I ate. Sounds great right? Well not really.

I rotate injection sites properly but I don’t have enough fat on my thighs or arms for injections. So I end hitting places that haven’t healed from the last time I injected there. Years go by and I swear I am all scar tissue now. I’ve brought it up with my endocrinologist before and they tell me I need to be better about rotating and re-educate me on it when I tell them I do rotate properly.

I tried googling for some home remedies but everything says the same thing “be better about rotating… In severe cases cosmetic surgery may be required.”

The only thing that ever works for me is going on a low/no carb diet for a while but it never lasts long since I’m vegetarian and without meat it gets boring fast. So I was wondering if anyone here might have some helpful ideas/experiences?


Do you have access to the inhaled insulin Afrezza? You would still need to inject a long-acting insulin, and you may still need occasional but smaller injections of short-acting, but it would reduce the amount of insulin you’re injecting over all.

I have scar tissue areas from childhood, and I find using really short, really fine pen needles means I can (mostly) comfortably inject in areas where there is not much tissue under the skin. I use 4 mm/32 gauge “ultra-fine” and go in on an angle depending on the area.You can also find 33G and recently in Europe I saw 3.5mm/34G, which you may be able to buy online.

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I have tons of scar tissue despite religious rotation. It just seems to be the way it is for me. I agree with @beacher Afrezza is awesome and I have been using it for over a year and it has given my skin a break, although I’m using some R along with it right now because Afrezza is pricey without insurance.

Using the shortest needles possible should give you a few more options in sites and you could try pulling your skin up and out from your body and injecting in the space it creates. Scar tissue is tough to get rid of but you could try some topical scar remedies or using neosporin after each injection. A new needle every time may be helpful since the sharper the needle the less damage it will do.

I have felt that way for as long as I can remember. I usually use an insulin pump rather than injections, but either way it involves putting a need in your body. I also get very frustrated when people tell me to try to rotate my sites, especially now that I also have a CGM (since that means twice as sites being used). I have been using mostly my upper body for as long as I have had an insulin pump, but before then (when I still used injections, meaning about 20 years ago) I often used my arms & legs. I still use those sites during the rare unfortunate situations where I am forced to do injections, but there is no way those sites would work for my pump or CGM. People have also suggested using my butt, but I can’t even think about doing that (since when do you tell somebody to stick it up their butt when giving medical advice?), because sitting on a needle (well, technically canula, but you know what I mean) is not very appealing.
I have tried for many years to gain weight, but 30 years and still no success. I’ve managed to keep everything functional (most of the time), but I always fear that day when my body will reach the point where I can no longer use some of these technologies. Maybe if we’re lucky the next breakthrough will let us avoid needles completely…

Hi @ThatOneGirl

I’ve never tried it, but have you thought about using a catheter that is made for injecting small amounts of medications, like insulin? I don’t know what it’s called in the US, but we have something called Insuflon in Denmark. It’s mostly used for children that are afraid of multiple daily injection, and you can inject up to 75 times in one cannula/catheter. You stick the needle through a membrane in the catheter and just dose like you normally would. I’m thinking if you can maybe have 2 or 3 stuck on your body at the same time, then you can rotate the injections between them, so you don’t inject insulin in the same place every time.

It’s just a thought - I don’t know if it would be relevant for you. :slight_smile: