Relationship Between Lipohypertrophy, Glycemic Control, and Insulin Dosing: A Systematic Meta-Analysis. in Diabetes technology & therapeutics / Diabetes Technol Ther. 2024 May;26(5):351-362. doi: 10.1089/dia.2023.0491. Epub 2024 Feb 12.
2024
ASL Torino 4
Tipo pubblicazione
Systematic Review
Autori/Collaboratori (13)Vedi tutti...
Mader JK
Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Fornengo R
Dipartimento di Area Medica, ASL TO4 S.S.D. di Diabetologia, Chivasso, Italy.
Hassoun A
Department of Medicine, Fakeeh University Hospital, Dubai, United Arab Emirates.
et alii...
Abstract
Background: Lipohypertrophy is a common complication in patients with diabetes receiving insulin therapy. There is a lack of consensus regarding how much lipohypertrophy affects diabetes management. Our study aimed to assess the potential correlation between lipohypertrophy and glycemic control, as well as insulin dosing in patients with diabetes. Methods: We performed a systematic review followed by a meta-analysis to collect data about glycemic control and insulin dosing in diabetic patients with and without lipohypertrophy. To identify relevant studies published in English, we searched medical databases (MEDLINE/PubMed, Embase, and CENTRAL) from 1990 to January 20, 2023. An additional hand-search of references was performed to retrieve publications not indexed in medical databases. Results of meta-analyses were presented either as prevalence odds ratios (pORs) or mean differences (MDs) with 95% confidence intervals (95% CIs). This study was registered on PROSPERO (CRD42023393103). Results: Of the 5540 records and 240 full-text articles screened, 37 studies fulfilled the prespecified inclusion criteria. Performed meta-analyses showed that patients with lipohypertrophy compared with those without lipohypertrophy were more likely to experience unexplained hypoglycemia (pOR [95% CI]?=?6.98 [3.30-14.77]), overall hypoglycemia (pOR [95% CI]?=?6.65 [1.37-32.36]), and glycemic variability (pOR [95% CI]?=?5.24 [2.68-10.23]). Patients with lipohypertrophy also had higher HbA1c (MD [95% CI]?=?0.55 [0.23-0.87] %), and increased daily insulin consumption (MD [95% CI]?=?7.68 IU [5.31-10.06]). Conclusions: These results suggest that overall glycemic control is worse in patients with lipohypertrophy than in those without this condition.
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PMID : 38215209
DOI : 10.1089/dia.2023.0491
Keywords
Humans; Insulin/administration & dosage/adverse effects/therapeutic use; Hypoglycemic Agents/administration & dosage/adverse effects; Glycemic Control/adverse effects; Blood Glucose/analysis/drug effects; Glycated Hemoglobin/analysis; Diabetes Mellitus, Type 2/drug therapy/blood/complications; Diabetes Mellitus, Type 1/drug therapy/blood/complications; Hypoglycemia/chemically induced/epidemiology; Diabetes; Glycemic Control; Insulin-injection technique; Lipohypertrophy; Meta-analysis; Systematic review;