Lipohypertrophy contributing to severe diabetic ketoacidosis in type 1 diabetes: An increasing problem in the context of the COVID-19 pandemic?

A 57-year-old man with type 1 diabetes was admitted with diabetic ketoacidosis during the COVID-19 pandemic. On examination, there was evidence of severe lipohypertrophy on his abdomen. Repeated injection of subcutaneous insulin into areas of lipohypertrophy was thought to have contributed to the development of ketoacidosis.