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Question of Week | Abdominal lumps and insulin injections

JL is 67 years old, with a BMI of 23 and A1C of 7.6% and injects insulin 4 times a day to manage their type 1 diabetes. On visual inspection, you notice that there are many areas of lipohypertrophy on JL’s abdominal region.

Which of the following interventions would be the best recommendation?

  1. Switch to 50/50 insulin twice daily.
  2. Stop bolus insulin and switch to a GLP-1 RA.
  3. Switch bolus injections to inhaled insulin.
  4. Use a higher gauge needles to enhance absorption.

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