Abstract:
BACKGROUND:Lipohypertrophy (LH) is a complication of insulin therapy. We assessed LH prevalence, risk factors, insulin usage, and clinical and health economic effects in China. METHODS:In four cities, 401 adult patients injecting insulin ≥1 year were surveyed for diabetes/insulin injection history and practices, pen needle reimbursement (PNR), and health resource utilization, followed by structured examination and HbA1c testing. Differences between those with and without LH were evaluated by Student's t-test or the Wilcoxon rank sum test. Insulin costs were calculated. RESULTS:Patients were 59.6 ± 11.5 years old; 50% male; 93.5% type 2 diabetes. LH prevalence was 53.1%. Compared to those without LH, patients with LH had higher body mass index (BMI; 26 vs. 24.8 kg/m2) and HbA1c (8.2% vs. 7.7% [66 vs. 61 mmol/mol]), took 11 IU (0.13 IU/kg or 31.7%) more insulin costing $1.4 versus $1.0 (RMB 9.5 vs. 6.8) daily, reused PNs more times, and had less PNR (all P ≤ 0.003). LH patients correctly rotated injection sites less often (67.6% vs. 92.3%, P < 0.0001). By stepwise logistic regression, BMI, needle reuse frequency, and PNR remained modestly associated with LH prevalence (odds ratios [OR] <1.9; P ≤ 0.03); weight-adjusted insulin dose and incorrect site rotation showed ORs of nearly 7 and 8.4, respectively (P ≤ 0.001). Extrapolated to 9 million insulin-injecting patients in China and adjusted for therapy adherence, LH-related excess annual insulin consumption cost is estimated at nearly $297 million (RMB 2 billion). CONCLUSIONS:LH is common in China and associated with worse glycemic control, despite nearly one-third greater insulin consumption, with large cost implications. Proper injection technique education may reduce LH prevalence.
journal_name
Diabetes Technol Therjournal_title
Diabetes technology & therapeuticsauthors
Ji L,Sun Z,Li Q,Qin G,Wei Z,Liu J,Chandran AB,Hirsch LJdoi
10.1089/dia.2016.0334subject
Has Abstractpub_date
2017-01-01 00:00:00pages
61-67issue
1eissn
1520-9156issn
1557-8593journal_volume
19pub_type
杂志文章abstract::Subcutaneous (s.c.) injections of identical insulin doses may lead to considerable intra- and inter-individual differences in the current metabolic control of patients with diabetes mellitus. This well-known variability of the metabolic effect of insulin hampers practical insulin therapy considerably. The aim of this ...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,评审
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,收录出版
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journal_title:Diabetes technology & therapeutics
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,多中心研究
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,评审
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 临床试验,杂志文章,多中心研究
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,评审
doi:10.1089/dia.2010.0146
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:Faster aspart is insulin aspart (IAsp) in a new formulation, which in continuous subcutaneous insulin infusion (CSII) in subjects with type 1 diabetes has shown a faster onset and offset of glucose-lowering effect than IAsp. METHODS:This double-blind, randomized, crossover active-controlled trial compared 2...
journal_title:Diabetes technology & therapeutics
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更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Glucose monitoring based on sampling skin interstitial fluid (ISF) is being developed as an alternative to fingerstick blood glucose monitoring. Time delays between rapidly changing levels of glucose in blood and interstitial fluid have been reported in the literature to be between 5 and 20 minutes. This stu...
journal_title:Diabetes technology & therapeutics
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更新日期:1999-04-01 00:00:00
abstract:BACKGROUND:Internet technology has been proven to be a successful tool for the management of patients with multiple medical conditions. The purpose of this study was to demonstrate the feasibility of monitoring glucose control in indigent women with gestational diabetes mellitus (GDM) over the Internet. METHODS:Women ...
journal_title:Diabetes technology & therapeutics
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abstract:BACKGROUND:Insulin initiation and optimization is a challenge for patients with type 2 diabetes. Our objective was to determine whether safety and efficacy of AIR inhaled insulin (Eli Lilly and Co., Indianapolis, IN) (AIR is a registered trademark of Alkermes, Inc., Cambridge, MA) using a simplified regimen was noninfe...
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更新日期:2009-09-01 00:00:00
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更新日期:2009-01-01 00:00:00
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2014-09-01 00:00:00
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journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
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更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:The hyperinsulinemic euglycemic clamp is the gold standard for assessment of insulin resistance and requires frequent, accurate measurements of blood glucose concentrations, typically utilizing the YSI 2300 STAT Plus™ glucose analyzer (YSI, Inc., Yellow Springs, OH). Despite its accuracy, the YSI has several...
journal_title:Diabetes technology & therapeutics
pub_type: 杂志文章
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章,评审
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更新日期:2011-09-01 00:00:00
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