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A 2016 review in Diabetes Technology and Therapeutics found that consistent site rotation reduced subcutaneous lipohypertrophy incidence by 67% compared with fixed-site injection in a cohort of 58 insulin-dependent patients [7]

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therefore, plain radiography of the lumbar spine typically reveals degenerative changes (Figure 4)

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Catching and correcting a confirmed deficiency early is generally simpler and less costly than treating the complications that a long-standing deficiency can cause