Abstract
IntroductionThe objective of this study was to investigate the frequency of lipohypertrophy (LH) and the associated risk factors in young patients with type 1 diabetes mellitus (T1DM).MethodsThis cross-sectional study was conducted on a sample of 174 patients with T1DM (aged 13–18 years) treated with multiple daily insulin injections for a minimum duration of 1 year. The study was performed at the Diabetes Treatment Center, Prince Sultan Military Medical City (Riyadh, Saudi Arabia), between July 2015 and September 2015. Information regarding patients’ age, weight, height, adjusted body mass index (BMI), period of the diabetic condition, length of needle used, number of injections per day, injection locations, insulin regimen, and glycosylated hemoglobin (HbA1c) were recorded. LH was assessed using the palpation technique.ResultsNearly 46% of patients were found to reuse needles, while 42.5% failed to alternate the injection site and 23% revealed unexplained hypoglycemic events. A substantial percentage of patients (approximately 47%) showed grade 1 LH, followed by 33.7% with grade 2 and 19.3% with grade 3 LH. A higher frequency of LH was observed in the thigh region (n = 28, 33.7%) than in the arm, which was second highest (n = 23, 27.7%). Patients aged ≥16 years showed a higher frequency of LH than those aged <16 years. Patients with uncontrolled diabetes mellitus had a greater likelihood of having LH (59.5%) than those with controlled diabetes (20.8%). Significant differences in LH were observed based on needle length, needle reuse, and rotation of the injection sites. On performing regression analysis, the independent risk factors for LH were found to be as follows: higher BMI, higher HbA1c, a higher number of injection sites, a higher rate of needle reuse and failed to alternate the injection site.ConclusionAs the frequency of LH was found to be high in Saudi patients with T1DM, it is essential to educate patients on the risk factors for LH and on diabetic control.
Highlights
The objective of this study was to investigate the frequency of lipohypertrophy (LH) and the associated risk factors in young patients with type 1 diabetes mellitus (T1DM)
Over the past 3 eras, the incidence T1DM has been rising in Saudi Arabia and the prevalence of T1DM in Saudi Arabian children and adolescents is currently 109.5 per 100,000 people [1, 2]
A total of 121 (69.5%) patients were identified with uncontrolled diabetes (HbA1c[7%)
Summary
The objective of this study was to investigate the frequency of lipohypertrophy (LH) and the associated risk factors in young patients with type 1 diabetes mellitus (T1DM). Methods: This cross-sectional study was conducted on a sample of 174 patients with T1DM (aged 13–18 years) treated with multiple daily insulin injections for a minimum duration of 1 year. In Saudi Arabia, type 1 diabetes mellitus (T1DM) has been identified as among the most common endocrine metabolic disorders in children and adolescents, and is accompanied by serious acute and chronic complications [1, 2]. Patients need exogenous insulin throughout their lifetime to survive, either via multiple injections every day or via continuous subcutaneous insulin infusion if required [3,4,5]. Injections or an insulin pump can be used to administer insulin [3,4,5]
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