19
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Prevalence of lipohypertrophy in insulin‐treated diabetes patients: A systematic review and meta‐analysis

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Aims/Introduction

          Insulin‐treated diabetes patients are at high risk for lipohypertrophy ( LH), but this clinical problem has been overlooked by some medical professionals. In addition, studies differed from each other significantly in regard to the prevalence of LH. The present systematic review aimed to determine pooled prevalence levels of LH among insulin‐injecting diabetes patients.

          Materials and Methods

          Four electronic databases (PubMed, EMBASE, The Cochrane Library and Scopus) were searched for eligible studies from their inception until April 2017, and reference lists were searched manually to identify additional studies. Studies containing data on LH in patients with diabetes mellitus were included. Meta‐analysis was carried out with a random effects model.

          Results

          A total of 26 studies with a total of 12,493 participants met the inclusion criteria. Meta‐analysis showed that the pooled prevalence of LH was 38% (95% confidence interval [ CI] 29–46%, I 2 = 99.1%). The main influence on LH was the type of diabetes mellitus. The pooled prevalence of LH among patients with type 2 diabetes mellitus was higher than patients with type 1 diabetes mellitus (49%, 95% CI 23–74% vs 34%, 95% CI 19–49%). The pooled prevalence of LH of studies involving a mixed type of diabetes mellitus was 37% (95% CI 25–48%, I 2 = 98.3%).

          Conclusion

          The prevalence of LH was high in insulin‐treated diabetes patients. It showed that diabetes nurses should screen for LH regularly in their patients, and teach them how to prevent LH in their daily management of diabetes mellitus.

          Related collections

          Most cited references34

          • Record: found
          • Abstract: found
          • Article: not found

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

          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.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: found
            Is Open Access

            Kidney Disease and Related Findings in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study

            OBJECTIVE Kidney disease manifests clinically as elevated albumin excretion rate (AER), impaired glomerular filtration rate (GFR), or both, and is a cause of substantial morbidity and mortality in type 1 diabetes (T1D). The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study tested whether intensive diabetes therapy (INT) aimed at lowering glucose concentrations as close as safely possible to the normal range reduces the risks of kidney disease and other diabetes complications. RESEARCH DESIGN AND METHODS In the DCCT, 1,441 participants with T1D were randomly assigned to INT or conventional diabetes therapy (CON) for a mean duration of 6.5 years. Subsequently, participants have been followed for 18 years in the ongoing observational EDIC. Standardized longitudinal measurements of AER, estimated GFR, and blood pressure were made throughout the DCCT/EDIC. RESULTS During the DCCT, INT reduced the risks of incident microalbuminuria (AER ≥40 mg/24 h) and macroalbuminuria (AER ≥300 mg/24 h) by 39% (95% CI 21–52%) and 54% (29–74%), respectively. During EDIC years 1–8, participants previously assigned to DCCT INT continued to experience lower rates of incident microalbuminuria and macroalbuminuria, with risk reductions of 59% (39–73%) and 84% (67–92%), respectively. Beneficial effects of INT on the development of impaired GFR (sustained estimated GFR <60 mL/min/1.73 m2) and hypertension became evident during combined DCCT/EDIC follow-up, with risk reductions of 50% (18–69%) and 20% (6–21%), respectively, compared with CON. CONCLUSIONS In the DCCT/EDIC, INT resulted in clinically important, durable reductions in the risks of microalbuminuria, macroalbuminuria, impaired GFR, and hypertension.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Results and analysis of the 2008-2009 Insulin Injection Technique Questionnaire survey.

              The efficacy of injection therapy in diabetes depends on correct injection technique and, to provide patients with guidance in this area, we must understand how they currently inject. From September 2008 to June 2009, 4352 insulin-injecting Type 1 and Type 2 diabetic patients from 171 centers in 16 countries were surveyed regarding their injection practices. Overall, 3.6% of patients use the 12.7-mm needle, 1.8% use the 12-mm needle, 1.6% use the 10-mm needle, 48.6% use the 8-mm needle, 15.8% use the 6-mm needle, and 21.6% use the 5-mm needle; 7% of patients do not know what length of needle they use. Twenty-one percent of patients admitted injecting into the same site for an entire day, or even a few days, a practice associated with lipohypertrophy. Approximately 50% of patients have or have had symptoms suggestive of lipohypertrophy. Abdominal lipohypertrophy seems to be more frequent in those using the two smaller injection size areas, and less frequent in those using larger areas. Nearly 3% of patients reported always injecting into lipohypertrophic lesions and 26% inject into them sometimes. Of the 65% of patients using cloudy insulins (e.g. NPH), 35% do not remix it before use. It is clear from the latest survey that we have improved in certain areas, but that, in others, we have either not moved at all or our efforts have not yielded the results we expected. The results of the present survey are available online on a country-by-country and question-by-question basis at http://www.titan-workshop.org. © 2010 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Blackwell Publishing Asia Pty Ltd.
                Bookmark

                Author and article information

                Contributors
                hehong1962@126.com
                Journal
                J Diabetes Investig
                J Diabetes Investig
                10.1111/(ISSN)2040-1124
                JDI
                Journal of Diabetes Investigation
                John Wiley and Sons Inc. (Hoboken )
                2040-1116
                2040-1124
                23 October 2017
                May 2018
                : 9
                : 3 ( doiID: 10.1111/jdi.2018.9.issue-3 )
                : 536-543
                Affiliations
                [ 1 ] Department of Nursing Affiliated Hospital of Nantong University Nantong China
                [ 2 ] Nursing School of Nantong University Nantong China
                [ 3 ] Department of Endocrinology Affiliated Hospital of Nantong University Nantong China
                Author notes
                [*] [* ] Correspondence

                Hong He

                Tel.: +86‐513‐8505‐2298

                Fax: +86‐513‐8505‐2298

                E‐mail address: hehong1962@ 123456126.com

                [†]

                These authors contributed equally to this work.

                Author information
                http://orcid.org/0000-0002-1542-3669
                Article
                JDI12742
                10.1111/jdi.12742
                5934253
                28862814
                72e8e568-c535-4cd5-8b50-d661aa5e4c21
                © 2017 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 21 May 2017
                : 06 August 2017
                : 21 August 2017
                Page count
                Figures: 3, Tables: 2, Pages: 8, Words: 5308
                Categories
                Original Article
                Articles
                Clinical Science and Care
                Custom metadata
                2.0
                jdi12742
                May 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.3.7.2 mode:remove_FC converted:03.05.2018

                diabetes mellitus,lipohypertrophy,meta‐analysis
                diabetes mellitus, lipohypertrophy, meta‐analysis

                Comments

                Comment on this article