Insulin lumps?

How common are those "insulin lumps" I've seen mentioned on some sites - where a big lump will form around an insulin injection site that's used too often?

I just started with a Lantus pen a month ago, along with Victoza. I do Lantus on the left, Victoza on the right - and I try to move around the stomach area but I haven't started using other sites yet.

"Common" is a tough term to define.

Insulin pumps are used by a significant, but minority proportion of diabetics. The majority of pumpers are type I; a rather small proportion of Type II diabetics use pumps.

If you are not on a basal/bolus regimen for treating your diabetes, you will with almost 100% certainty not be eligible for insurance coverage for a pump. Pumps deliver ALL insulin your body needs, not just supplementation.

Basically, once you're in the position of having to essentially fully replace the functioning of your pancreas with externally administered insulin and your brain, a pump can be an incredible alternative to many shots throughout the day. Because of the prodecural convenience (push a few buttons on a device vs. all that's involved with an injection), and technology that helps manage and track insulin.

If you're achieving good control with Lantus and Victoza, and are not suffering any serious side-effects, you're probably better sticking with that treatment regimen.

However, if you are not achieving good control (a1c >=7%), or want to commit to tight control (a1c <=6%, minimize BG excursions post-meal, get as close as possible to a non-diabetic BG profile, etc.) then a pump is, in my experience and opinion, a necessary tool.

Hi Dave,

I very much appreciate your quick and informative response - thank you - it's just that I was asking about "Lumps" not "pumps". Oops! Talking about big lumps that apparently form if you inject insulin in the same spot too often.

BWAHAHAHAHA! Man did I misread that one!

I am embarassed...

Hahahaha! Adorable.

the lumps could probably just be a small hematoma, pooling of blood below the skin, i get them, just press on the lump after the injection for about 10 - 15 seconds. that's what my nurse told me. I have bruises everywhere from my MDI injections, not sure how to get rid of them.

So, now an on-topic answer.

You're talking about Lipohypertrophy (Wikipedia). Your best bet is to do a search here on TuD -- there's been lots of discussion about it -- and on the internet. The Wikipedia entry I linked is a good start.

Short answer: Not that common, and somewhat stubborn to get rid of.

I think you might be referring to lipohypertrophy. I'll let folks google that themselves to see how troubling it can be if you have a severe case. I'm not sure how common it is, but it's definitely one reason to be vigilant about rotating your sites as much as you can. If you're only injecting your stomach, you might want to consider broadening your rotation to include the sides of your abdomen and around to the "love handle" area, as well as rear real estate. Recent posts about how to inject in the gluteus maximus (not actually into the muscle of course) have some useful charts.

EDIT: Looks like Dave & I were posting at the same time.

Brilliant minds and all...

oh, i thought the OP actually had these and thought, 'hum it couldn't be lipohypertrophy YET as he/she just started taking lantus a month ago.' Thus OP was just asking about potential or hypothetical 'lumps'.

NPH and LantusĀ® caused lumps (lipohypertrophy) and I had them for many years but when LevemirĀ® came on the market and I switched, the lumps and bumps vanished. I have been pumping for many years now and have never experienced any lipohypertrophy at my pump sites.

Sarah, yes - just hypothetical... would like to prevent them if I can!

Dave and Shadow - thank you!

Hi there!

When I was on shots...there was a point where I would ned 21 units of Lantus..What I would need to do was divide it into two shots. It wasn't the best solution but it definitely would help with injecting such big amounts of insulin and preventing lumps. Also, I know that you use more Lantus than the Victoza, I wouldn't just do one on the right and one on the left, I would alternate BOTH. Another suggestion, I would use my arms or legs for the fast acting one (Victoza)...and leave your stomach or the fattiest place on your body for the Lantus!

Oh those are great suggestions!

I'll also talk to the doctor about splitting my Lantus, as I'm at 48 units at the moment. I guess that's really high? I think the dose must also have to do with your size - I'm quite tall and I'm also overweight.. she started me at 20 units and said it was a small dose.