An Effective Intervention for Diabetic Lipohypertrophy: Results of a Randomized, Controlled, Prospective Multicenter Study in France

作者：Campinos Catherine; Le Floch Jean Pierre; Petit Catherine; Penfornis Alfred; Winiszewski Patrice; Bordier Lyse; Lepage Marie; Fermon Catherine; Louis Jacques; Almain Catherine; Morel Didier; Hirsch Laurence; Strauss Kenneth W^*

来源：Diabetes Technology & Therapeutics, 2017, 19(11): 623-632.

DOI：10.1089/dia.2017.0165

• Insulin
• Injections
• Needles
• Subcutaneous
• Lipodystrophy
• Lipohypertrophy

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.+/- 15.7 years; men 70.7%; body mass index >30kg/m(2): 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.

• 出版日期2017-11