Factors Associated with Lipohypertrophy in Diabetic Patients with Insulin Therapy

• Main Authors: Su-Ying Yen, 顏素瑛
• Other Authors: Pi-Li Lin
• Format: Others
• Language: zh-TW
• Published: 2018
• Online Access: http://ndltd.ncl.edu.tw/handle/qa5s6p

碩士 === 美和科技大學 === 護理系健康照護碩士班 === 106 === Background：Lipohypertrophy is the most common complication of insulin therapy. There are many problems found clinically in insulin therapy and insulin injection techniques. Lipohypertrophy not only affects the blood sugar control and quality of life of diabetic patients, but also increases the medical costs. Purpose：To explore the incidence and related factors of lipohypertrophy in insulin with diabetes. Methods：This study used a cross-sectional, retrospective study method. The research consisted of 877 patients who had been using insulin for at least six months and from five diabetes specialist clinics in South Taiwan. The data was from January 1, 2017 to March 31, 2018, using the tool of “Diabetes Injection Therapy Drug Follow-up Table” for insulin injection assessment. The descriptive and inferential statistical analysis was performed using the tool “SPSS 22.0 for windows statistical suite software”. Results：The incidence of lipohypertrophy in diabetes patients with insulin therapy was 16.4% (n=144) and the higher incidence of lipohyperthrophy was found at abdominal injection site (11.3%). The demographic analysis compares two groups with and without lipohyperthrophy and found higher incidence was associated with type 1 diabetes (31.5%), longer duration of diabetes (19.1±8.5 years), longer insulin injection (9.0±5.5 years), higher proportion of premixed insulin (39.6%), higher injection frequency (2.2±1.1 times), obese position of BMI, use of needles over 4mm, repeated use of needles, wrong choice of injection site, abnormal rotation of injection sites, total insulin dose increased 11 units and more hypoglycemic events (21.8%) (p<0.05). Logistic regression analysis has a negative correlation between smoking history and lipohypertrophy. The longer insulin injection duration, more insulin injection frequency, more length of syringe needle, select wrong injection site, and incorrect injection site rotation pattern were positively correlated with adipose tissue hyperplasia. Conclusions：This study found that incorrect insulin injection techniques can increase the occurrence of lipohypertrophy, lead to blood glucose poor control, increased risk of hypoglycemia, and increased insulin dose. Therefore, clinicians need to carry out a review of insulin injection sites and pay attention to the occurrence of related risk factors of lipohypertrophy to improve the quality of care.