An Effective Intervention for Diabetic Lipohypertrophy: Results of a Randomized, Controlled, Prospective Multicenter Study in France
| Autor: | Laurence J. Hirsch, Marie Lepage, Jacques Louis, Alfred Penfornis, Kenneth Strauss, Patrice Winiszewski, Jean-Pierre Le Floch, Didier Morel, Lyse Bordier, C Fermon, Catherine Campinos, Catherine Almain, Catherine Petit |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty Lipodystrophy Injections Subcutaneous Endocrinology Diabetes and Metabolism medicine.medical_treatment 030209 endocrinology & metabolism Pen needles Injections 03 medical and health sciences 0302 clinical medicine Endocrinology Patient Education as Topic Intervention (counseling) Internal medicine Diabetes mellitus Diabetes Mellitus medicine Humans Hypoglycemic Agents Insulin Prospective Studies 030212 general & internal medicine Aged business.industry Subcutaneous Lipohypertrophy Original Articles Middle Aged medicine.disease Surgery Medical Laboratory Technology Treatment Outcome Multicenter study Needles Female France business Body mass index |
| Zdroj: | Diabetes Technology & Therapeutics |
| ISSN: | 1557-8593 1520-9156 |
| Popis: | Background: Lipohypertrophy (LH) is highly prevalent and is potentially harmful to insulin-injecting patients. Methods: In this study, we assessed the impact of injection technique (IT) education, including use of a 4-mm pen needle on insulin-treated patients with clinically observed LH in a randomized, controlled, prospective multicenter study in France with follow-up of 6 months. Intensive education and between-visit reinforcement were given to the intervention group. Control patients received similar messages at study outset. Results: A total of 123 patients were recruited (age 52.1 ± 15.7 years; men 70.7%; body mass index >30 kg/m2: 34.2%; type 1: 53.7%; years with diabetes mellitus: 18.1 ± 10.5), of which 109 patients were included in the final analysis. The intervention group (n = 53) showed a significant decrease of total daily dose of insulin (average at baseline: 54.1 IU) at 3 months (T-3) and 6 months (T-6), reaching just over 5 IU versus baseline (P = 0.035). Corresponding, although not significant, decreases occurred in controls (n = 56); between-group differences were not significant. There were significant decreases in HbA1c (up to 0.5%) at T-3 and T-6 in both groups, with no significant differences between groups. A significant number of intervention patients improved their IT habits; about half achieved ideal IT habits by T-3 versus a quarter of control patients. By T-6, 2/3 of intervention patients achieved either ideal or acceptable IT habits, while only 1/3 of control patients did. Conclusions: Our intervention was effective in both study arms, however, to a greater degree and more rapidly in the intervention group. Widespread application of this intervention could be highly cost-effective. |
| Databáze: | OpenAIRE |
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