Endocrine Abstracts

Introduction: Lipohypertrophy (LH) is a chronic complication of diabetes mellitus that could develop in any age, any injection site, and be any size. At present time, new method, as ultrasonography of subcutaneous fat, of LH diagnostics were appeared.

Design: The aim of this study has been to estimate efficiency of insulinotherapy in diabetic patients after LH was diagnosed by ultrasonography. This study was done on 50 diabetic patients (31 females and 19 males) who had been under the treatment with insulin a mean 10 years. Ultrasonography of subcutaneous fat was used in assessing LH in typical injection sites. All patients injected insulin in physiological regimen. HbA1c level, fasting and postprandial glucose, episodes of hypoglycaemia, body mass and BMI were evaluated at the moment of LH and after 6 month in all patient. Results were considered to be statistically significant P<0.05.

Results: BMI reduced from 26.34±6.07 kg/m² to 25.25±4.06 kg/m² (P<0.05). Body mass decreased from 72.44±15.75 kg to 70.08±15.02 kg (P<0.05). Also good glycaemic control was demonstrated by measuring glucose and HbA1c level. Thus fasting glucose reduced from 9.03±3.98 mmol/l to 7.11±2.95 mmol/l (P<0.05). Postprandial glucose decreased from 10.27±3.72 mmol/l to 9.34±2.61 mmol/l (P<0.05). HbA1c level reduced from 9.27±2.32% to 7.43±1.52% (P<0.05). Frequency of hypoglycaemia reduced from 1.97±2.23 to 1.10±0.91 in month (P<0.05).

Conclusions: There were significant improvement of all estimated parameters which characterised the diabetes compensation after changing injected sites because of detected by ultrasonography LH. Since ultrasonography of subcutaneous fat is more sensitive than classic LH diagnostics, it might be used in general clinical practice instead of common detection of LH. Thus, early LH diagnostics can provide to good glycaemic control.