Abstract
Background: Lipohypertrophy (LH) is a frequent cutaneous complication in people with insulin-treated type-2 DM (IT-T2DM). Its pathogenesis is not fully known, however. Retinal and kidney microangiopathy (MIA) is also frequent in such patients, especially in case of poor metabolic control. Aim: To assess whether specific nailfold video-capillaroscopy (NVC) patterns could be identified in MIA-affected IT-T2DM patients, thus eventually helping explain LH pathogenesis. Methods: 50 IT-T2DM patients with LH and 50 without LH undergoing NVC were enrolled. All followed a multiple daily injection regimen and had established retinal and renal microangiopathic complications. Results: While confirming expected MIA-related skin changes in both groups, our data failed to detect any specific NVC pattern in LH-affected patients yet showed the most severe NVC changes to be significantly associated with HbA1c values over 9%. Conclusion: Severe NVC-assessed MIA lesions reflect longstanding poor metabolic control in IT-T2DM rather than contributing to LH pathogenesis.
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