Improper rotation of sites and reuse of needles are the leading causes of LH in Indian T1DM patients, which, in turn, significantly increases the risk of GV and UH.
Background: Lipohypertrophy (LH) at insulin injection sites is a preventable complication in patients of diabetes mellitus taking insulin injection therapy. We evaluated the prevalence, contributing risk factors, and consequences of LH along with awareness regarding correct insulin injection technique amongst these diabetic patients.
Methodology: It is a cross sectional observational questionnaire-based study conducted at a tertiary health centre in Nagpur, India. 31 type 1 diabetics (T1DM) and 43 type 2 diabetics (T2DM) who are on insulin injection therapy for over one year, were randomly selected and presence of LH was evaluated through visual and palpation techniques. Demography, anthropometry, awareness of correct insulin injection technique were noted using a validated questionnaire. Their effect on LH was determined along with its correlation with complains of unexplained hypoglycaemia (UH).
Results: The prevalence of LH amongst T1DM is 48.39% and amongst T2DM is 18.60%. Prevalence was significantly higher in T1DM than in T2DM (p=0.0133). Young age (p=0.0042), Male gender (p=0.0011), decreased duration of diabetes (p=0.0281), improper rotation of the correct sites (p=0.0032) significantly increased the prevalence of LH. Occurrence of UH were significantly higher in patients with LH (p=0.0078). Independent risk factors for LH amongst T2DM include less age (p=0.0358), Male gender (p=0.0048) and improper rotation of sites (p=0.0071). No independent risk factors were found significant for LH amongst T1DM as well as no significance was observed for prevalence of LH with respect to needle reuse, number of injections taken per day and total daily dosage of insulin, which may be regarded to low sample size.
Conclusion: Improper rotation of injection sites, Male gender, younger age, lesser duration of diabetes and T1DM contribute to a higher prevalence of LH, which in turn will increase the risk of UH.
Disclosure
S.S. Gupta: None. S. Chaoji: None. S. Gupta: None. K. Gupta: None. S. Gathe: None.
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