Avoid-Lipo Study
Research type
Research Study
Full title
Avoidance of insulin-induced lipohypertophy in people with diabetes: A feasibility study of implementation of ultrasound scanning within diabetes clinics
IRAS ID
349033
Contact name
Lalantha Leelarathna
Contact email
Sponsor organisation
Imperial College London
Duration of Study in the UK
1 years, 2 months, 31 days
Research summary
Diabetes is a common long-term health condition globally. Type 1 diabetes requires insulin treatment right from diagnosis. Similarly, many people living with type 2 diabetes eventually require insulin injections as the condition progresses. A common but often underappreciated complication associated with insulin use is the formation of fatty tissue at injection sites, known as “Lipos,” a shorthand for “Lipohypertrophy.” These Lipos can interfere with insulin absorption, altering the insulin action profile. This results in glucose fluctuations, increasing the risk of high and low glucose levels.
In current medical practice, Lipos are assessed through clinical examination, specifically by physically palpating the injection sites. Research indicates that approximately 40% of insulin-treated individuals may have Lipos. However, manual palpation can often overlook these fatty deposits. Ultrasound scanning (USS) presents a more effective method for detecting Lipos. Studies that have employed ultrasound scanning have reported a much higher prevalence, reaching up to 86%.
The primary goal of this study is to ascertain whether the avoidance of ultrasound-identified Lipos can improve glucose regulation. We are concentrating on individuals using continuous glucose monitoring who exhibit high glucose fluctuations and less time within their target range. By focusing on this population, we increase our chances of identifying those with Lipos.
Participants will undergo a clinical examination followed by an ultrasound scan. Those found to have Lipos will receive guidance on avoiding those sites and education on insulin injection techniques. We will periodically collect glucose data over the next 24 weeks. After this period, participants will return for a follow-up ultrasound scan. Additionally, we will train members of the diabetes care team to conduct the ultrasound scans. Data from this study may also be utilized to develop artificial intelligence algorithms aimed at identifying Lipos in future ultrasound scans.
REC name
London - Surrey Research Ethics Committee
REC reference
25/PR/0324
Date of REC Opinion
24 Mar 2025
REC opinion
Favourable Opinion