Prevalence and risk factors of lipohypertrophy in insulin-injecting patients with diabetes.
Prevalence and risk factors of lipohypertrophy in insulin-injecting patients with diabetes.
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DOI：
10.1016/j.diabet.2013.05.006
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发表时间：
2013-10-01
影响因子：
7.2
通讯作者：
Amaya, M
中科院分区：
文献类型：
--
作者：
Blanco, M;Hernandez, M T;Amaya, M
简介：我们的目的是评估脂肪增生（LH）的频率和它的关系，网站旋转，针头重复使用，葡萄糖变异性，低血糖和使用insulin.METHODS：该研究包括430名门诊注射胰岛素谁填写了一个广泛的调查问卷，关于他们的注射技术。然后，糖尿病护士检查他们的注射部位是否存在LH。结果：近三分之二（64.4%）的患者有LH。LH的存在和非旋转的网站之间有很强的关系，正确的旋转技术具有最强的保护价值，对LH。在正确旋转部位的患者中，只有5%有LH，而在LH患者中，98%没有旋转部位或旋转不正确。此外，39.1%的LH患者有不明原因的低血糖，49.1%的患者有血糖变异性，而无LH的患者分别只有5.9%和6.5%。LH也与针头重复使用有关，当针头使用> 5次时，风险显著增加。有和无LH患者的每日胰岛素总剂量平均分别为56和41 IU/天。这15 IU的差异相当于西班牙医疗保健系统每年的总成本超过1.22亿美元。这也是第一个研究中，使用超声波允许的“回声签名”的描述为LH.CONCLUSION：正确的注射部位旋转似乎是预防LH，这是与降低血糖变异性，低血糖，胰岛素消耗和成本的关键因素。
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.