Effect of Lipohypertrophy on Accuracy of Continuous Glucose Monitoring in Patients With Type 1 Diabetes

Repeated delivery of insulin in the same location induces a local reaction in the subcutaneous adipose tissue, often leading to lipohypertrophy (1,2). Advanced lipohypertrophy leads to slower, erratic insulin absorption due to the fibrous, relatively avascular nature of the tissue (3). Although lipohypertrophied tissue is commonly used for continuous glucose monitoring (CGM) sensor sites, the effect on sensor performance is unknown. Therefore, we analyzed the accuracy of sensors used simultaneously in lipohypertrophied and normal tissue. In this prospective, multicenter study, subjects with type 1 diabetes and lipohypertrophy (≥3 cm diameter) were instructed to wear two Dexcom G4 Platinum sensors simultaneously: one in lipohypertrophied tissue and the second in normal tissue for 2 consecutive weeks. This procedure was then repeated on each subject with new sensors being worn simultaneously for a second 2-week period. Blood glucose (BG) readings from Bayer CONTOUR NEXT meters served as reference (4), with absolute …