Lumps (Hyperlipotrophy)- is it better with injections or pump?

I have a bad hyperlipoatrophy on my legs and arms. I have been Diabetic for 23 years and have been using injections. My consultant is offering me to try going on a pump as a way to make my hyperlipotrophy better. She suggested that this would give my injection sites a break, as it will be only one needle per 3 days rather than 10 needles per day… What are your thoughts on this? Are there any of you who have tried to use pump to make hiperlypotrophy better?

I have never experienced hyperlipoatroph. But using the pump is less skin piercings. Needles are deeper and more numerous. Just speculation but I would think injections would be worse. just a guess.


I’ve been a T1D for nearly 48 years … probably the first 43 of those on MDI. I started with the smallest needles available that in the early years was 26 and 27 gauge 1/2” (13 mm) needles and over time, those got thinner and shorter. That probably for me averaged 6 injections per day.

For the past 5 years, I’ve been on both CGM and a pump which is an “injection” count of 1 per week for the CGM and 2+ per week for the cannula (I use soft sets). So a reduction from about 6 per day to about 3 per week … but the sensor and infusion set “inserters” are larger diameter needles than 31 gauge pen needles. I guess they are about 26-27 gauge, but don’t know for sure.

My experience: scar tissue lumps have gone down significantly, but not disappeared completely, with pump and CGM. Note: in my case, this is all on my belly.

To me, just one more benefit of CGM and pumping over MDI. But, lumps weren’t the primary (or even secondary) reason that I moved from MDI to CGM and then a pump.

Good luck,


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I always understood that hypertrophy was caused by the insulin, not the needle scarring, i.e., that it was because constantly squirting insulin subcutaneously in the same location has this effect on the tissues. So it’s more a matter of just rotating your locations religiously, which you’re supposed to do with a pump too. Of course with a pump, the location becomes less absorptive over the course of a few days, so you have to move it for that reason.


I started on MDI about 25 years ago then switched to a pump a little over 10 years ago before switching back to MDI around 4 years ago. I developed more scar tissue while using the pump. I suspect having insulin and a cannula continuously under the skin in one spot for several days causes a lot more scar tissue than several brief needle pokes dosing insulin at separate sites.

I switched off of the pump because the scar tissue affected the reliability of my infusion sites (Basal needs changed over the life of a site) and delayed absorption at sites (making insulin dosages unpredictable).

I went back on Lantus and Humalog and experienced better control and the freedom of not being attached to something all the time.

The cgm has caused no scar tissue problems for me- as far as I can tell. The sensor wire that stays under your skin is incredibly small and there’s no insulin infusion. I think a cgm causes negligible scar tissue compared to a pump or injections. The cgm has been a life changer for me, and I highly recommend it regardless of whether you use a pump or MDI.

I use an inhaled insulin, Afrezza, for many of my meal doses now, so I have very little scar tissue anymore. I think Afrezza is a better fit for people who are using a cgm.


@katers87 Do you split your Lantus dose into 2 injections, and if so approx how much do you take in the AM vs PM?

I split my dose into 2 injections. The first is at 9 am and the second at 4 pm. The dose is the same or the one at 4 is one unit less- daily basal dose of 20 to 24 units depending on time of the month.

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Thanks @katers87 :slightly_smiling_face:

Merry Christmas and a safe and happy holidays to you and your family :santa:

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Happy holidays to you too!! :blush:

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I have given shots for over 60 yrs. Now I am giving at least 7 shots a day. Other than a small bruise every once in a while, my skin is fine. One would never know that I have given thousands of shots. The CGM is marking my skin a tiny bit though, although it eventually clears up.

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I used the Dex G4 for over 4.5 years with sensor placement exclusively in my lower abdomen. I found when the transmitter was getting near the end of its life that I had to find lesser used areas on my abdomen for the sensor to be effective.

When I moved to the G6, I found I had to abandon the abdomen and let the scar tissue heal.

W/R/T infusion sites, I agree that scar tissue is more likely to form, which is why I am very strict on rotating to different areas.

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I was an MDI person for 30 years. I’m now on the Medtronics pump and CGM for 8 years. I was in the construction business so ‘site rotation’ wasn’t high on my list of injection preparations. My lumps and bumps became so severe and painful on my right side ‘love handle’ area that I had them surgically removed shortly after I started pumping. It took about 3 months for the area to heal and be use-able again. It was well worth it.

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@JD112 How traumatic a procedure was it to have the lipohypertrophy removed (via liposuction presumably)?

I mentioned the bumps to my Dr when I was scheduling surgery for removing some scar tissue from an old hernia surgery. He said he could remove them during the scar tissue removal as it was a fairly straight forward procedure. As I recall it was not a big deal for me as I didn’t have any real discomfort from the procedure. I believe he simply cut into the area and removed the bumps and lumps. We did discuss liposuction as I was afraid it wouldn’t be covered by insurance. He put my mind at ease when he said ‘this is not a liposuction procedure’. It was a very low impact event and well worth the slight discomfort I suffered. I did end up with a 4" scar.