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

ABSTRACT: Lipohypertrophy (LH) is highly prevalent and is potentially harmful to insulin-injecting patients.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.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.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.

SUBMITTER: Campinos C 

PROVIDER: S-EPMC5750448 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature