INS and diabetes mellitus: Whereas, health care system with limited resources, lack of trained health personnel/diabetic care team, having a mother as the primary caregiver, less than 3 clinic visits per year,), in subjects with lipohypertrophy, known celiac disease, age at diabetes onset and diabetes duration, insulin treatment regimen, adherence to insulin therapy, practice of self-monitoring, in ability of the patient or family to use and afford treatment expenditures were identified risk factors in developing countries [6, 7, 9, 10, 24].