Insulin injection lipohypertrophy — SCE Endocrinology MCQ

Correct answer: C — Injection-site rotation with anticipatory insulin-dose review

The best answer is “Injection-site rotation with anticipatory insulin-dose review”. Insulin absorption from lipohypertrophy is delayed and unpredictable; moving to normal tissue can increase effective delivery, so technique correction must be paired with close glucose and dose review to prevent hypoglycaemia. “Increase every insulin dose before changing injection sites” is less appropriate because dose escalation can produce hypoglycaemia once normal absorption resumes “Inject intramuscularly to overcome the lump” is less appropriate because intramuscular injection accelerates unpredictably and is not the corrective technique “Continue injecting into lipohypertrophy to maintain familiar technique” is less appropriate because repeated trauma perpetuates the lesion and glycaemic variability “Stop insulin and substitute oral semaglutide after considering diabetes type” is less appropriate because insulin may be essential and cannot be withdrawn without establishing diabetes type and a safe alternative

Reference: NICE NG17: Type 1 diabetes in adults — recommendations. https://www.nice.org.uk/guidance/ng17/chapter/Recommendations