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Scar tissue build up?

Shannon27

Well-Known Member
Messages
292
Type of diabetes
Type 1
Treatment type
Insulin
Hi everyone!

Ladies may be more able to comment on this, so lads be warned!

I feel i have quite a nice figure at the minute - but i have what i call "a ledge". This is the area especially on either side of my belly button and a little further down, where i have been injecting for 12-13 years. I call it a ledge because the rest of my belly is quite flat, that bit just really sticks out.

Question - is this just flab, which i should be able to lose with exercise? Or might scar tissue build up from repeated injections in the area? I'm noticing more insulin lumps as i inject recently (after i take the needle out) and try to massage them to get the insulin to absorb better.

I have another area like this - there seems to be a bump that doesn't look normal, but feels totally normal. This is in an area where i used to inject frequently but no longer do.

This post may seem vain, but i'm curious. Do i just need to get to the gym (highly plausible) or do i need to rotate sites a lot more? If anyone has a suggestion to reduce scar tissue, much appreciated
 
Hi @Shannon27 this "ledge" sounds like lipohypertrophy. Repeated jabs in the same place will cause fatty lumps to appear and will hamper your absorption of insulin. You do really need to rotate your injection sites more. I know from experience that these "ledges" can take a while to go
 
Hi @Shannon27 Do you get your sites checked over by your DSN or consultant ? It would be a good idea to mention this at your next appointment so they can see if there's any issues with your sites, I try and rotate around a number of areas but getting these sites looked at is down to me to mention as it's not normally bought up during an appointment.
 

I have the same issue, years of injecting in my stomach and bad practice of reusing needles led to lipohypertrophy. I lost a lot of weight and was quite lean but it was still very visible. The fat deposits take years to go if at all I was told (only real solution is liposuction). I've not injected in the area for at least 3 years and its still there.
 

Hi @Juicyj , it's not something we tend to talk about, now i know it may be something related to my injections (thank you all for giving a name to the potential problem) i will definitely be asking them to check my sites.

I don't know how much my DSN, as great as she is, would be able to suggest, beyond moving my sites around. I use my belly for convenience more than anything. I may give it a few months and see if anything changes after it's had a chance to heal. I know it will take longer than this to start diminishing but hopefully a break will be good for my belly!
 
I know what you mean about convenience, I have heard other ladies mention about it, to be honest I have extra skin here due to carrying a large baby, so I do take care with my sites for my pump and try to rotate as much as I can, have only heard of lipo as a potential solution too, I did read about a t1 lady last year who did this to her belly and had a successful outcome, if I find the article i'll post it but can't remember her name.
 
To the people saying to rotate between sites, do you mean between belly, arms, legs, etc. or do you mean between spots around the belly button?
For instance, I try to inject around the area between the green circles in the image (avoiding recently used spots), is that enough?

I ask because, after 14 years, I'm starting to wonder if I just have a little flab or if it's lipohypertrophy.
(I'm male, btw)
 

Both, you need to rotate around the area and around injection sites. If you constantly inject around the belly button you naturally have less space to inject and will be injecting in the same place more often. You need to rotate around legs, stomach, arms and buttocks as much as possible.

Its likely that you have lipohypertrophy if you have been injecting around the same spot for 14 years, but get it checked out to be sure. Also make sure you don't use the same needle, always put a new one on. I always inject long lasting into buttocks and rotate around the others for fast acting.
 
You should be aware that insulin tends to act quicker when injected in the thigh as opposed to the belly.

Regarding your green circles, my injection areas are all the way from one side to the other, and about 4" above and below my belly button. Maybe four times the area you have there! (I am pretty fat though, so my tummy is of larger than average size)
 

Insulin does not act quicker in the thigh compared to belly in general.

Generally the fastest acting is the abdomen (unless you use love handles), then arms, then legs, then buttocks.
 
Muneeb said:
Insulin does not act quicker in the thigh compared to belly in general.

Generally the fastest acting is the abdomen (unless you use love handles), then arms, then legs, then buttocks.
Click to expand...
To be honest i never really thought about different areas being better for fast absorption - do you know how much by, on average? Obviously it depends on the person!
 
Shannon27 said:
To be honest i never really thought about different areas being better for fast absorption - do you know how much by, on average? Obviously it depends on the person!
Click to expand...


I've uploaded this in the past. This is from the FIASP tests. It is quite significant.

I generally find that if I inject in the arms or abdomen, most of the insulin is absorbed by 2 hours, in the leg its around 3 hours.
So fast acting carbs I always inject in the abdomen or arms, for low carb meals or high fat/protein meals I will use the legs as the insulin is absorbed slower and hence better fit for glucose uptake.
 
Muneeb said:
Insulin does not act quicker in the thigh compared to belly in general.

Generally the fastest acting is the abdomen (unless you use love handles), then arms, then legs, then buttocks.
Click to expand...
Yep, sorry, you're right for the general case. Bad assumption. Except for me, where short of sticking it in a vein, thighs are the fastest site I've tried. Don't you just love how consistent diabetes is?
 
I had an appointment last week and, indeed, I had some lipohypertrophy just bellow the bellybutton (it is tiny, I hope it will vanish soon).
I tried injecting on my thighs, but it was difficult and felt a kind of numbness on my leg atfterwards. Apparently I don't have enough fat in my arms and couldn't inject there. Instead, I increased the area around the bellybutton I inject.
What I noticed, and don't know if it's related, is that my levels dropped (and now tend to stay lower) since I changed sites.
Is it because the insulin absorption in these lumps is lowered and now I'm actually injecting where I should?
(already decreased basal dose to compensate)
 
Sounds like that's exactly whats happened
 

Lipohypertrophy is well known to cause erratic insulin absorption and unpredictability. It is most likely the cause of the insulin absorption issues. Just remember to keep rotating!
 
Hi I was recently told by my diabetic nurse that you can inject any where left to right from the belly button to the bust line and your thighs though like you i worry about my thighs so they only get injected at the weekend
 
Shannon27 said:
To be honest i never really thought about different areas being better for fast absorption - do you know how much by, on average? Obviously it depends on the person!
Click to expand...

Hi,
Yes is important to rotate your sites. After 47 yrs of injecting including pump sites in the last 20 yrs i personally find it harder to find sites which work and don't hurt. Legs used to be good but now are too painful. Is a challenge going for above or below waist belt lines, away from hip bones, pelvic bones, breast bones etc etc but rather have the 3 times s week pump site then 6 times a day injections!
When i used to inject i found buttocks easy to reach and painless.
 
porl69 said:
I know from experience that these "ledges" can take a while to go
Click to expand...

I'vev got a lump in my belly that I developed during one of my pregnancies. My youngest child turns 25 in May.... My GP once suggested that I could have it surgically removed....
 
Hello,

I will have been type 1 for 20 years next year. Probably for the first 15 years I injected into my stomach. It was abnormal and I referred to it as my ski slope. It was lipohypertrophy. I took the advice of my consultant and DSN and stopped injecting there, two years later and absolutely no change. I paid privately to have liposuction due to resistance from my diabetic team to give any support. Best decision I ever made. I’ve uploaded a before pic and one week post surgery.
 
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