Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

What should a patient showing signs of lipohypertrophy be advised to do regarding injection sites?

1. Begin antibiotic treatment under the direction of a dermatologist

2. Apply warm compresses twice a day until swelling decreases

3. Avoid injecting into those areas until swelling is gone; rotate injection sites

4. Masses should be removed surgically

The correct answer is: Avoid injecting into those areas until swelling is gone; rotate injection sites

A patient with signs of lipohypertrophy, which is characterized by thickened or swollen areas of subcutaneous tissue due to repeated insulin injections, should indeed be advised to avoid injecting into those areas until the swelling decreases and to rotate injection sites to prevent further complications. This approach is fundamental in managing lipohypertrophy because injecting insulin into the affected areas can lead to unpredictable absorption of the hormone, resulting in poor blood glucose control. By avoiding these areas, the patient allows the tissue to heal and return to a more normal state, improving insulin absorption and overall diabetes management. Additionally, rotating injection sites helps to prevent the formation of new lipohypertrophic areas and maintains effective insulin delivery. The other options do not address the immediate concerns of effective insulin delivery and diabetes management. Antibiotic treatment would not be appropriate unless there is an infection, applying warm compresses might provide temporary relief but does not resolve the issue of site selection, and surgical removal of masses is not necessary unless they pose significant health risks or complications, which is typically not the case in uncomplicated lipohypertrophy.