INS and diabetes mellitus: The pathophysiology of lipohypertrophy in patients with diabetes has not been fully elucidated, but some authors suggest that it may result not only from the lipogenic properties of insulin, promoting the growth of fat cells but also from mechanical damage to subcutaneous tissue through repeated and improper injections in the same location.9 The rationale for including glucagon-like peptide 1 receptor agonists (GLP-1-RAs) in the meta-analysis was based on the observation that some studies reported the occurrence of lipohypertrophy in patients using GLP-1-RA.58