Errors in insulin treatment management and risk of lipohypertrophy
| العنوان: | Errors in insulin treatment management and risk of lipohypertrophy |
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| المؤلفون: | Giuseppe Maria Pozzuoli, Franco Crisci, Maria Barone, Mario Laudato, Bianca Pozzuoli |
| المصدر: | Acta Diabetologica. 55:67-73 |
| بيانات النشر: | Springer Science and Business Media LLC, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Adult, Blood Glucose, Male, medicine.medical_specialty, Lipodystrophy, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, 030209 endocrinology & metabolism, Hypoglycemia, Palpation, Injections, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Risk Factors, Hyperinsulinism, Internal medicine, Diabetes mellitus, Prevalence, Internal Medicine, medicine, Humans, Hypoglycemic Agents, Insulin, Medication Errors, 030212 general & internal medicine, Aged, Glycemic, Aged, 80 and over, medicine.diagnostic_test, business.industry, Lipohypertrophy, General Medicine, Middle Aged, medicine.disease, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Metabolic control analysis, Female, Complication, business |
| الوصف: | Lipohypertrophy (LH) represents the most common skin-related complication associated with insulin therapy. Our aim is to estimate the prevalence of LH among insulin-treated patients, to identify its association with errors in insulin injection technique and storage, and the correlation between LH, risk of hypoglycemia, and glycemic control. Consecutive patients with T1DM or T2DM, attending a diabetes clinic for a routine visit, were administered an anonymous questionnaire investigating the modalities of insulin injection, the correct use of pen device, insulin storage, and reported frequency of hypoglycemic episodes. The presence of LH was assessed by inspection and palpation of injection sites. Overall, 352 patients were enrolled (mean age 68 ± 12 years, 43.2% males, 88.9% with T2DM, mean duration of insulin therapy 9.1 ± 8.6 years). The prevalence of LH was 42.9%. At multivariate analysis, the strongest correlates of LH were not spacing injections (OR 20.4; 95% CI 10.5–39.6) and not rotating the site of injection (OR 2.01; 95% CI 1.08–3.75). Increasing doses of insulin and longer duration of insulin therapy also increased the risk of LH. The presence of LH was associated with a 2.7 times higher risk of severe hypoglycemia. Higher daily insulin doses, lack of rotation of injection sites, and keeping insulin in use in the refrigerator were independent correlates of higher HbA1c levels. Insulin injection technique is suboptimal in many patients, highlighting the need for improved patient education. Increasing the awareness of the importance of preventing lipohypertrophy and insulin injection errors represents an important tool to reduce the clinical, social, and economic burden of diabetes. |
| تدمد: | 1432-5233 0940-5429 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5b1fbec70f9baf9ecc7ed63c35e23931Test https://doi.org/10.1007/s00592-017-1066-yTest |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....5b1fbec70f9baf9ecc7ed63c35e23931 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14325233 09405429 |
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