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Based on the foregoing, the effectiveness in the treatment of doxycycline of changing the type of insulin from porcine insulin to human insulin is understandable: antibodies produced for porcine insulin did not interact with human insulin and their insulin-blocking effect on adipocytes was removed. Currently, lipoatrophy at the injection sites of insulin is not observed, but if they did occur, then, I believe, it would be effective to replace human insulin with analogues of human insulin and, vice versa, depending on which insulin developed lipoatrophy.

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The so-called lipohypertrophy is still observed and is not associated with hypertrophy of adipocytes, as the name would seem to suggest, but with the development of scar tissue at the site of subcutaneous injection, with a soft elastic consistency that mimics local hypertrophy of subcutaneous adipose tissue.

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Doxycycline of this adverse reaction is unclear, as is the genesis of any keloid, but the mechanism is probably traumatic, since these sites occur primarily in individuals who rarely change the injection site and injection needle (it must be discarded after each injection!).

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Therefore, the recommendations are obvious - to avoid the introduction of Doxycycline into the lipohypertrophic area, especially since the absorption of insulin from it is reduced and unpredictable. Be sure to change each time the injection site and needles for insulin injection, which patients must be provided with in sufficient quantities.

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And finally, the most difficult to differentiate inflammatory reactions at the injection site of insulin, which are usually manifested by seals in the subcutaneous fat that occur the next day after Doxycycline and slowly resolve over days or weeks. Previously, they were all usually classified as delayed-type allergic reactions, but given the high purity of insulin preparations, they are no longer considered as such.

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It should be noted to the patient that the vials (insulin pen with cartridge) used for insulin therapy should be stored at room temperature. The quality of the insulin preparation will not suffer, especially if you follow the general rule that the vial (cartridge) is used for no more than a month and thrown away after this period, even if insulin remains in it.

The method of treatment is to inject insulin into the deep layers of the subcutaneous fat so that the inflammation does not appear on the skin, which is of the greatest concern. These reactions do not affect the effect of treatment, and in my practice they have never become a reason for changing the drug, i.e. reactions are expressed rather moderately.