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Diabetes Metab. 2013 Oct;39(5):445-53. doi: 10.1016/j.diabet.2013.05.006. Epub 2013 Jul 22.

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

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  • 1Novartis 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.

Copyright © 2013 Elsevier Masson SAS. All rights reserved.

KEYWORDS:

Consommation d’insuline; Costs; Coûts; Injection d’insuline; Injection rotation; Insulin consumption; Insulin injection; Lipodystrophie (LH); Lipodystrophy; Lipohypertrophy; Rotation d’injection

PMID:
23886784
[PubMed - indexed for MEDLINE]
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