Introduction: Lipodystrophy is a common complication of insulin therapy. The objective of our study was to evaluate the frequency of lipodystrophy in diabetic patients and its contributing factors. Materials and methods: A prospective study including insulin-treated patient for more than 6 months. The variables studied were treatment, injection techniques, hypoglycemia and its criteria.The results for the group of patients with lipodystrophy were compared to the group without lipodystrophy. Results: During the study period, 1000 patients were included. The prevalence of lipodystrophies was 48%. The main location was the arms in 84%. The predisposing factors for the development of lipodystrophy were essentially: the lack of rotation of injection sites (p<0.0000000001), the practice of the injection fold, the use of insulin syringes more than 6 times (p=0.0000004) and the number of education sessions. Unexplained moderate hypoglycemia was present in 72% of patients with lipodystrophy versus 30% in patients without lipodystrophy. For insulin injection techniques, the vector used was the insulin syringe in 92% of patients. The antiseptic was used in 12% of patients. The injection fold was performed in 43% of patients and released in 15% of patients. Needle retention after injection was observed in 41% of patients. Rotation of injection sites was noted in 55% of patients. All patients reported reusing the needle and 97% used it more than 4 times. Conclusion: The predictive factors for lipodystrophy were essentially the lack of site rotation, the impracticality of the injection fold and the abusive reuse of syringes. This requires further education and assessment of insulin-treated patients.