Like most T1Ds, on diagnosis I was advised to rotate injection sites to avoid the risk of Lipodystrophy. However, the most recent clinical guide to Diabetes - ISBN 9781118976043, published this year - states (p. 92) that "Lipodystrophy (localised subcutaneous fat loss) is rarely seen with modern insulins." Instead "Repeated injection into the same subcutaneous site may, in the long term, give rise to a local accumulation of fat, Lipohypertrophy, because of the local trophic action of insulin". The pictures in the book suggest that rotation to the extent of varying injection site on the abdomen alone is insufficient to prevent Lipohypertrophy, and instead the ideal would be to vary location on the body, e.g. thighs, arms, in addition to the more typical abdomen. The obvious concern is the different absorption profiles for different areas of the body, increasing the complexity and/or unpredictability of bolus injections, already variable enough. (thankfully, long term basals like Tresiba can be injected almost anywhere without adverse effect). So I've been wondering roughly to what extent do T1Ds on MDI vary injection site on average? For instance, do you tend only to vary the location on the abdomen, or do you regularly vary location on the body too?
