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According to the American Diabetes Association's Standards of Medical Care in Diabetes, proper injection technique and systematic site rotation are essential for optimal medication absorption and to prevent lipohypertrophy (thickening of fatty tissue) or lipoatrophy (loss of fatty tissue) at injection sites

The women report severe side effects that, in two cases, continued for at least a year after discontinuing the use of the drug

doi: 10.1001/jamadermatol.2013.4294