Epidemiological and nursing perspectives on insulin-derived amyloidosis: a scoping review

Insulin-related amyloidosis (IDA) is a subcutaneous complication that may interfere with insulin absorption. Although early detection may prevent the deterioration of glycemic control, this condition is often overlooked. In this scoping review, we aimed to summarize the epidemiological characteristics of IDA and identify future research challenges from a nursing perspective.

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guidelines, a comprehensive literature search was conducted using PubMed, Scopus, Web of Science, and the Japan Medical Abstracts Society database. The eligible studies comprised original articles and case reports regarding patients with histopathologically confirmed IDA published in English or Japanese between January 2009 and August 2022.

No epidemiological research articles, but a total of 29 case-based reports regarding 38 patients, were identified. Most of the patients were male (n=29), they were aged 27-87 years, and both type 1 and type 2 diabetes were represented. The abdominal region was the most common site of lesions (n=23). Histopathology was the primary diagnostic method, although some patients were also evaluated using diagnostic imaging. Many of the patients noticed subcutaneous masses but delayed seeking medical care, and some continued injecting insulin into the affected sites. Medical consultations were often prompted by poor glycemic control or complications of diabetes.

This review highlights the paucity of epidemiological research on IDA and underscores the importance of early detection and education. Limited awareness regarding injection-site abnormalities and the lack of early assessments may contribute to delays in diagnosis.