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Global Health Econ Sustain Treatment and costs of skin lipohypertrophy

Figure 1. Photos depicting lipohypertrophy (LH) caused by incorrect injection technique. Clockwise from top-left photo: (1) Two LH protrusions at both
sides of the navel; (2) LH plastron on the right arm; (3) small LH plastron becoming evident after pinching maneuver; (4) unilateral abdominal LH; (5) two
symmetrical paraumbilical LH nodules; and (6) anomalous LH distal to the crook of the elbow. Source: Photos taken by the authors.

merely suggesting the need for patient education or assigned to an intensive program of education on correct
recommending soothing cream (Scaramuzza et al., 2015) injection techniques (intervention group [IG], n. 395
or skin liposuction as the best treatment solutions. Long- subjects) or educated on correct insulin injection methods
term skin preservation from needle injuries (Gusenoff, only during their first visit (control group [CG] n. 318
2014) is conducive for spontaneous LH healing, achieved subjects) (Gentile et al., 2021b; Gentile et al., 2021c; Gentile
primarily through intensive therapeutic education. et al., 2022c).
However, education-based approach may take a long
time to achieve the desired results, and as an emerging 3. Results
treatment that promises fast results, liposuction captures Our strategy search resulted in the identification of only
the attention of diabetic patients, especially women, who 38 cases from different reports and one case from a review
would prefer rapid and effective outcomes, which are not (Mangan et al., 2023), which described the use of different
possible with the utilization of soothing cream. techniques such as power-assisted liposuction, lipectomy-
This paper offers a comparison of clinical and economic associated liposuction, and laser-assisted liposuction
implications between systematic therapeutic education (Barak et al., 1996; Bernstein 1999; Bodansky & Browning,
(STE) and liposuction in the treatment of LH. 1992; Brun et al., 2007; De Mey et al., 1996; Gandolfi and
Thione 2009; Hardy et al., 1993; Hauner and Olbrisch 1994;
2. Data and methods Samdal et al., 1993;) (Table 1). Moreover, a case report
We carried out an extensive search in the leading has described surgical resection of a huge abdominal LH
scientific bibliographic databases (PubMed, Scopus, and supported by histopathologic approach as an avenue of
ResearchGate) for original scientific publications and LH treatment (Fujikura et al., 2005). Nevertheless, these
clinical case papers about “liposuction” in English. In techniques are proposed as appropriate LH treatment in the
addition, we sought for online articles from advertising American Diabetes Association guidelines 2023 due to the
sites to evaluate state-of-the-art and costs of liposuction lack of evidence-based indications (ElSayed et al., 2023).
using the following keywords: “liposuction diabetes” and Only less than one-fifth of the patients (16.6%)
“insulin-induced LH.” Results about the clinical outcomes reported improved postoperative glycemic control
and social costs of severe hypoglycemic events (i.e., those following liposuction treatment, but all of them (100%)
requiring help from a third party or hospitalization) expressed satisfaction with the procedure implemented.
gleaned from online articles were compared with those of Minor skin surface abnormalities were present in 11.1%
LH-affected patients with T2DM that we had randomly of the patients. Several authors reported adipocyte volume

Volume 2 Issue 2 (2024) 2 https://doi.org/10.36922/ghes.2424