Lipohypertrophy in Elderly Insulin-Treated Patients With Type 2 Diabetes
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REVIEW
Lipohypertrophy in Elderly Insulin-Treated Patients With Type 2 Diabetes . Giuseppina Guarino . Teresa Della Corte . Giampiero Marino . Alessandra Fusco . Gerardo Corigliano . Sara Colarusso . Marco Piscopo . Maria Rosaria Improta . Marco Corigliano . Emilia Martedi . Sandro Gentile
Domenica Oliva . Viviana Russo . Rosa Simonetti . Ersilia Satta . Carmine Romano . Sebastiano Vaia . Felice Strollo
on behalf of the AMD-OSDI Study Group on Injection Techniques . Nefrocenter Network and
Nyx Start-up Study Group Received: September 11, 2020 / Accepted: October 20, 2020 Ó The Author(s) 2020
ABSTRACT Background: The number of older adults with insulin-treated diabetes mellitus (DM) is steadily increasing worldwide. Errors in the insulin injection technique can lead to skin lipohypertrophy (LH), which is the accumulation of fat cells and fibrin in the subcutaneous tissue.
This work was conducted on behalf of the Association of Italian Diabetologists–Italian Diabetology Health Operators (AMD-OSDI) Study Group on Injection Techniques, and the Nefrocenter Network and Nyx Startup Study Group. A list of study collaborators and study investigators can be found in the Acknowledgements section. S. Gentile G. Guarino T. Della Corte (&) G. Marino Department of Internal Medicine, Campania University ‘‘Luigi Vanvitelli’’, Naples, Italy e-mail: [email protected] G. Guarino e-mail: [email protected] G. Marino e-mail: [email protected] S. Gentile Diabetes Unit AID Stabia, Nefrocenter Research and Nyx Start-Up, Naples, Italy e-mail: [email protected] T. Della Corte Nutrition, Nefrocenter Research and Nyx Start-Up, Naples, Italy
While lipohypertrophic lesions/nodules (LHs) due to incorrect insulin injection techniques are very common, they are often flat and hardly visible and thus require thorough deep palpation examination and ultrasonography (US) for detection. Detection is crucial because such lesions may eventually result in poor diabetes control due to their association with unpredictable insulin release patterns. Skin undergoes fundamental structural changes with aging, possibly increasing the risk for LH. We have therefore investigated the effect of age on the prevalence of LHs and on factors potentially associated with such lesions. Methods: A total of 1227 insulin-treated outpatients with type 2 DM (T2DM) referred to our A. Fusco G. Corigliano M. Corigliano V. Russo Diabetes Unit, Italian Association for Diabetes (AID) Napoli, Naples, ItalyA. Fusco e-mail: [email protected] G. Corigliano e-mail: [email protected] M. Corigliano e-mail: [email protected] V. Russo e-mail: [email protected]
S. Colarusso Diabetes Unit, AID Benevento, Benevento, Italy e-mail: [email protected]
Diabetes Ther
diabetes centers were consecutively enrolled in the study. These patients underwent a thorough clinical and US evaluation of the skin at injection sites, as previously described, with up to 95% concordance betweenthe clinical and US screening techniques.
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