Impact of insulin injection induced lipohypertrophy on multidimensional glucose variability in patients with type 1 diabetes mellitus
10.3760/cma.j.cn311282-20220811-00476
- VernacularTitle:1型糖尿病患者胰岛素注射皮下脂肪增生与多维度血糖波动的相关性研究
- Author:
Hong WANG
1
;
Jian YU
;
Meijing ZHOU
;
Min SHEN
;
Yun SHI
;
Min ZHU
;
Jing HANG
;
Mei ZHANG
;
Jingjing XU
;
Tao YANG
Author Information
1. 南京医科大学第一附属医院内分泌科 210029
- Keywords:
Diabetes mellitus, type 1;
Lipohypertrophy;
Glucose variability;
Flash glucose monitoring system
- From:
Chinese Journal of Endocrinology and Metabolism
2023;39(3):236-241
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study aimed to investigate the effect of lipohypertrophy induced by insulin injection on blood glucose fluctuation in patients with type 1 diabetes mellitus.Methods:A total of 80 patients with type 1 diabetes mellitus were recruited between June 2021 and December 2021 from the First Affiliated Hospital of Nanjing Medical University. And these patients all received insulin injection more than six months. Lipohypertrophy was assessed by ultrasound scanning, and blood glucose fluctuation was evaluated using the flash glucose monitoring system(FGM). Univariate analysis and multivariate linear regression were used to analyze the relationship of lipohypertrophy and and core indicators of blood glucose fluctuation.Results:Compared with patients without lipohypertrophy, patients with lipohypertrophy had higher mean amplitude of glycemic excursions(MAGE), coefficient of variation(CV), mean of daily differences(MODD), standard deviation(SD) of blood glucose, time above range(TAR), and high blood glucose index(HBGI; all P<0.05), while time in range(TIR) of glucose markedly become lower( P<0.01). Moreover, multivariate linear regression analysis showed that lipohypertrophy detected by ultrasound was an independent influencing factor of TIR( β=-9.423, P=0.032), MAGE( β=1.114, P=0.039), CV( β=4.304, P=0.041), MODD( β=0.717, P=0.046) after adjusting for age at diagnosis, duration of insulin injection, fasting C-peptide, and daily dose of insulin per unit weight. Conclusion:Lipohypertrophy increases glycemic variability and imposes negative impact on glycemic control rate in patients type 1 diabetes mellitus.
