Insulin injection technique errors can cause a high rate of skin lipohypertrophic lesions (LHs), but these lesions are often flat and barely visible, thus requiring thorough deep palpation examination and ultrasonography (US) for identification.

Detection of LHs is crucial to prevent poor diabetes control due to unpredictable insulin-release patterns.

The skin undergoes fundamental structural changes with aging, potentially increasing the risk for LHs.

In this study, 718 outpatients with type 2 diabetes mellitus with LHs were assigned to one of two age class subgroups (≤ 65 years and > 65 years) in order to evaluate whether age influences LH prevalence and various factors associated with LHs.

The older group was found to show a stronger association between LHs and poor habits, as well as with several clinical parameters, among which the most relevant were hypoglycemic events and glycemic variability.

The results suggest the need (1) to take specific actions to prevent and control the high risk of acute cardiovascular events expected to occur in older subjects in the case of hypoglycemic events, and (2) to identify and establish better-targeted, effective educational programs specifically in patients in the older age category.