Background and Objectives: Lipohypertrophy is a major complications of insulin therapy especially attributed to incorrect insulin technique. The objective was to determine the frequency of lipohypertrophy in diabetic population on insulin and its associations. Methods: This cross-sectional study was conducted at the Services Hospital Lahore from July 1st, 2020 to December 31st, 2020. Total of 363 diabetic patients, fulfilling the inclusion criteria were approached. The patients were examined and interviewed through a validated questionnaire. The data was stratified according to the age, gender, duration of diabetes, duration of insulin use, frequency of LH and duration since last instructions reviewed. The chi-square test was applied. Data was analyzed using SPSS 22. Results: Mean age of the study population was 49.71± 13.36 years. Majority were females (57.6%). LH was noted in 22.86% of participants (n=83). There was significant statistical difference noted (P <0.05) between different age groups as 29.7 % of patients in age group above 45 had LH as compared to 19.6% in the below 45 years age group. More females (28.2%) were having LH than the males (15.6%) with P<0.05. Also, significant difference was noted for needle reuse more than 10 times, more than two injections per day and longer duration since last instructions reviewed. No significant difference was noted between different devices for injection as well as for duration of diabetes. LH is strongly associated with hypoglycemia and hyperglycemia with P<0.05. Conclusion: A significant diabetic population on insulin has noted to have LH, and the risk is more with aged population, female gender, more injections per day and multiple time needle reuses. Risk of LH can be reduced by reinforcing education. doi: https://doi.org/10.12669/pjms.39.1.6134 How to cite this: Nawaz A, Hasham MA, Shireen M, Iftikhar M. Prevalence of Lipohypertrophy and its Associations in Insulin-Treated Diabetic Patients. Pak J Med Sci. 2023;39(1):---------. doi: https://doi.org/10.12669/pjms.39.1.6134 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background: Optimal glycaemic control in type 2 diabetics is of utmost importance in preventing the complications of diabetes which lead to increased morbidity and mortality related to the disease. Some studies have shown that vitamin D deficiency was prevalent in type 2 diabetic patients and was associated with poor glycaemic control. This study aimed to determine the vitamin D3 levels in type 2 diabetic patients and its association with glycaemic control. Patients and methods: This cross sectional study was carried out in the outdoor department of Medical Unit II of Sir Ganga Ram Hospital/Fatima Jinnah Medical University Lahore from Feb 10, 2019 to May 9, 2019. A total of 45 cases of type 2 diabetes mellitus were enrolled in this study after taking informed consent from them. Demographic details (name, age, gender, including duration of diabetes) were obtained and blood sample were taken for HbA1c and 25-OH vitamin D3 levels. Vitamin D deficiency was diagnosed by taking serum level <20 ng/mL as cut off. The data analysis was carried out in SPSS version 20. Quantitative variables like age and duration of diabetics were taken as mean and standard deviation. Qualitative variables, gender and vitamin D3 levels and HbA1c levels were taken as percentage. Post stratification chi-square test was applied taking p-value <0.05 as significant. Results: Out of 45 patients, 17 (37.78%) were male and 28 (62.2%) were female. Mean age was 49.56 ± 10.77 years. Mean duration of diabetes was 5.91 ± 3.74 years. Mean vitamin D levels were 36.36±17.9 ng/ml. Out of 45 patients, 7 (15.6%) were found deficient, 10 (22.2%) insufficient, 27 (60%) sufficient and 1 (2.2%) had vitamin D toxicity. Among the patients with sufficient vitamin D levels, 12 (44.4%) were male and 15 (55.5%) were female. Two (16.6%) male patients with sufficient vitamin D levels had good glycemic control as compared to none of the female patients. Two (16.6%) male and 2 (13.3%) female patients with sufficient vitamin D had fair HbA1c. Most of the patients had poor control of HbA1c despite sufficient vitamin D levels including 8 (66.6%) males and 13 (86.6%) females. Mean HbA1c concentration was 9.3±1.66%. Out of 45 patients, 2 (4.4%) had good glycaemic control, 5 (11.11%) had fair and 38 (84.4%) had poor control. It was seen that out of 7 vitamin D deficient, 6 (85.7%) had poor glycemic control, 1 (14.3%) had fair and none had good glycaemic control. The post stratification chi-square test was applied to determine the significant association between vitamin D levels and HbA1c and showed a p-value of 0.196 which is statistically insignificant. The Pearson correlation revealed a value of -0.012 which shows a negative correlation between vitamin D and HbA1c levels. Conclusions: No statistical significance could be established between vitamin D deficiency and poor glycemic control. There is a weak negative correlation between vitamin D and HbA1c levels showing that low Vitamin D levels are associated with higher HbA1c concentration.

Amongst diabetes, type 2 diabetes encompasses more than 80% and even higher percentage is present in un-industrialized countries. Kidney disease in diabetic patients is clinically characterized by increasing rates of urinary albumin excretion, starting from no albuminuria, which progresses to microalbuminuria, macro-albuminuria and eventually to End Stage Renal Disease. Dyslipidemia is observed in patients with DM and microalbuminuria. Total cholesterol increases significantly with albuminuria.Objectives:  Frequency of hypercholesterolemia in recent onset type-2 diabetics with microalbuminuria.Methodology:  The study was conducted in Department of Endocrinology & Metabolism, Services Hospital Lahore. Study was conducted and completed over a period of six months from 15th September 2014 to 15th March 2015. It was a cross sectional survey with non-probability, purposive sampling technique. 200 patients fulfilling the criteria were enrolled. Informed consent was obtained. Demographic information of each patient was noted. Urine was obtained and samples were sent to the laboratory of the hospital and reports were assessed. If the value of albumin is raised in urine analysis (as per operational definition) then albuminuria was labeled. In patients who were diagnosed as with albuminuria, total cholesterol was noted. If cholesterol was > 240 mg/dl, then hypercholesterolemia was labeled by researcher himself.Conclusion:  The results of the study conclude that frequency of microalbuminuria among patients of newly diagnosed type-2 diabetic mellitus is in agreement with other studies while the frequency of hyper-cholesterolemia in patients with microalbuminuria was also recorded higher which needs special physicians attention for its timely management so that patients can be prevented from severe cardio vascular morbidi-ties and mortality.