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

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

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Autores principales: Campinos, Catherine, Le Floch, Jean-Pierre, Petit, Catherine, Penfornis, Alfred, Winiszewski, Patrice, Bordier, Lyse, Lepage, Marie, Fermon, Catherine, Louis, Jacques, Almain, Catherine, Morel, Didier, Hirsch, Laurence, Strauss, Kenneth W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mary Ann Liebert, Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5750448/
https://www.ncbi.nlm.nih.gov/pubmed/29058477
http://dx.doi.org/10.1089/dia.2017.0165
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author Campinos, Catherine
Le Floch, Jean-Pierre
Petit, Catherine
Penfornis, Alfred
Winiszewski, Patrice
Bordier, Lyse
Lepage, Marie
Fermon, Catherine
Louis, Jacques
Almain, Catherine
Morel, Didier
Hirsch, Laurence
Strauss, Kenneth W.
author_facet Campinos, Catherine
Le Floch, Jean-Pierre
Petit, Catherine
Penfornis, Alfred
Winiszewski, Patrice
Bordier, Lyse
Lepage, Marie
Fermon, Catherine
Louis, Jacques
Almain, Catherine
Morel, Didier
Hirsch, Laurence
Strauss, Kenneth W.
author_sort Campinos, Catherine
collection PubMed
description Background: Lipohypertrophy (LH) is highly prevalent and is potentially harmful to insulin-injecting patients. Methods: 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. Results: A total of 123 patients were recruited (age 52.1 ± 15.7 years; men 70.7%; body mass index >30 kg/m(2): 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. Conclusions: 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.
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spelling pubmed-57504482018-01-03 An Effective Intervention for Diabetic Lipohypertrophy: Results of a Randomized, Controlled, Prospective Multicenter Study in France Campinos, Catherine Le Floch, Jean-Pierre Petit, Catherine Penfornis, Alfred Winiszewski, Patrice Bordier, Lyse Lepage, Marie Fermon, Catherine Louis, Jacques Almain, Catherine Morel, Didier Hirsch, Laurence Strauss, Kenneth W. Diabetes Technol Ther Original Articles Background: Lipohypertrophy (LH) is highly prevalent and is potentially harmful to insulin-injecting patients. Methods: 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. Results: A total of 123 patients were recruited (age 52.1 ± 15.7 years; men 70.7%; body mass index >30 kg/m(2): 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. Conclusions: 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. Mary Ann Liebert, Inc. 2017-11-01 2017-11-01 /pmc/articles/PMC5750448/ /pubmed/29058477 http://dx.doi.org/10.1089/dia.2017.0165 Text en © Catherine Campinos, et al., 2017; Published by Mary Ann Liebert, Inc. This Open Access article is distributed under the terms of the Creative Commons License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
spellingShingle Original Articles
Campinos, Catherine
Le Floch, Jean-Pierre
Petit, Catherine
Penfornis, Alfred
Winiszewski, Patrice
Bordier, Lyse
Lepage, Marie
Fermon, Catherine
Louis, Jacques
Almain, Catherine
Morel, Didier
Hirsch, Laurence
Strauss, Kenneth W.
An Effective Intervention for Diabetic Lipohypertrophy: Results of a Randomized, Controlled, Prospective Multicenter Study in France
title An Effective Intervention for Diabetic Lipohypertrophy: Results of a Randomized, Controlled, Prospective Multicenter Study in France
title_full An Effective Intervention for Diabetic Lipohypertrophy: Results of a Randomized, Controlled, Prospective Multicenter Study in France
title_fullStr An Effective Intervention for Diabetic Lipohypertrophy: Results of a Randomized, Controlled, Prospective Multicenter Study in France
title_full_unstemmed An Effective Intervention for Diabetic Lipohypertrophy: Results of a Randomized, Controlled, Prospective Multicenter Study in France
title_short An Effective Intervention for Diabetic Lipohypertrophy: Results of a Randomized, Controlled, Prospective Multicenter Study in France
title_sort effective intervention for diabetic lipohypertrophy: results of a randomized, controlled, prospective multicenter study in france
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5750448/
https://www.ncbi.nlm.nih.gov/pubmed/29058477
http://dx.doi.org/10.1089/dia.2017.0165
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