NDLI: Prevalence and risk factors of lipohypertrophy in insulin-injecting patients with diabetes.

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Prevalence and risk factors of lipohypertrophy in insulin-injecting patients with diabetes.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Blanco, M. Hernández, M. T. Strauss, K. W. Amaya, M.
Spatial Coverage	Spain
Description	Author Affiliation: Blanco M ( Novartis Pharma, Barcelona, Spain. Electronic address: mblanco.hernandez86@gmail.com.)
Abstract	INTRODUCTION: Our objective was to assess the frequency of lipohypertrophy (LH) and its relationship to site rotation, needle reuse, glucose variability, hypoglycaemia and use of insulin. METHODS: The study included 430 outpatients injecting insulin who filled out a wide-ranging questionnaire regarding their injection technique. Then, a diabetes nurse examined their injection sites for the presence of LH. RESULTS: Nearly two-thirds (64.4%) of patients had LH. There was a strong relationship between the presence of LH and non-rotation of sites, with correct rotation technique having the strongest protective value against LH. Of the patients who correctly rotated sites, only 5% had LH while, of the patients with LH, 98% either did not rotate sites or rotated incorrectly. Also, 39.1% of patients with LH had unexplained hypoglycaemia and 49.1% had glycaemic variability compared with only 5.9% and 6.5%, respectively, in those without LH. LH was also related to needle reuse, with risk increasing significantly when needles were used > 5 times. Total daily insulin doses for patients with and without LH averaged 56 and 41 IU/day, respectively. This 15 IU difference equates to a total annual cost to the Spanish healthcare system of > 122 million. This was also the first study in which the use of ultrasound allowed the description of an 'echo signature' for LH. CONCLUSION: Correct injection site rotation appears to be the critical factor in preventing LH, which is associated with reduced glucose variability, hypoglycaemia, insulin consumption and costs.
File Format	HTM / HTML
ISSN	12623636
Issue Number	5
Volume Number	39
e-ISSN	18781780
Journal	Diabetes & Metabolism
Language	English
Publisher	Elsevier
Publisher Date	2013-10-01
Publisher Place	France
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Metabolism Discipline Endocrinology Adipose Tissue Pathology Diabetes Mellitus, Type 1 Drug Therapy Diabetes Mellitus, Type 2 Hypoglycemic Agents Administration & Dosage Injections, Subcutaneous Adverse Effects Insulin Injuries Blood Glucose Metabolism Complications Epidemiology Female Guidelines As Topic Hemoglobin A, Glycosylated Humans Hypertrophy Etiology Male Middle Aged Odds Ratio Prevalence Primary Health Care Risk Factors Spain Young Adult Journal Article Multicenter Study
Content Type	Text
Resource Type	Article
Subject	Endocrinology, Diabetes and Metabolism Internal Medicine Endocrinology

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Prevalence and risk factors of lipohypertrophy in insulin-injecting patients with diabetes.