BES2021 Belgian Endocrine Society 2021 Abstracts (26 abstracts)
Lipohypertrophy monitoring study (LIMO): effect of injection site rotation and education on glycemic control
Bochanen N. 1 , Decochez K. 2 , Heleu E. 2 , Cuypers J. 3 , Vercammen C. 4 , Coremans P. 5 , Vanhaverbeke G. 6 , Shadid S. 7 , Keymeulen B. 8 , Bolsens N. 1 & De Block C 1
1University Hospital Antwerp, Endocrinology-diabetology-metabolism, Edegem, Belgium; 2AZ Jan Portaels, Department of Endocrinology, Vilvoorde, Belgium; 3AZ Turnhout, Department of Endocrinology, Turnhout, Belgium; 4Imelda ziekenhuis, Department of Endocrinology, Bonheiden, Belgium; 5AZ Nikolaas, Department of Endocrinology, Sint-Niklaas, Belgium; 6AZ Groeninge, Department of Endocrinology, Kortrijk, Belgium; 7Ghent University Hospital, Department of Endocrinology, Ghent, Belgium; 8Academic Hospital and Diabetes Research Center Vrije Universiteit Brussel, Endocrinology, Brussels, Belgium
Background and Aims: Incorrect injection technique can cause lipohypertrophy resulting in unpredictable insulin release. We aimed to assess the impact of a correct injection technique and lipohypertrophy on HbA1c, hypoglycemia and glucose variability.
Methods: 171 insulin-injecting people with diabetes were prospectively evaluated for 6 months. 146 subjects completed the study (75 type 1, 71 type 2). They were provided extensive education concerning injection technique via an online education platform (BD and MeTM) based on the international Forum for Injection Technique & Therapy Recommendations, encouraged to systematically use 4 mm needles and not reuse needles. Primary outcome parameter was the evolution between baseline and end-of-study percentage of needle re-use and injecting in a zone of lipohypertrophy vs glucometrics (HbA1c, hypoglycemia and glucose variability).
Results: At baseline, lipohypertrophy was present in 64%, 51% of patients injected in zones of lipohypertrophy, 37% rotated incorrectly and 96% reused needles. After the intervention, only 8% injected in a lipohypertrophy zone, 4% rotated incorrectly, and 21% reused needles. There was a significant reduction in severe hypoglycemia (from 15.8% to 4.1%, P < 0.001), number of unexplained hypoglycemias (from 47% to 16%, P < 0.001), and in the number of people with high glucose variability (from 64% to 30% P < 0.001). HbA1c (7.5 ± 1.2%) and total dialy insulin dose (62 ± 41 units) remained unchanged.
Conclusions: Online education on injection techniques focusing on avoidance of lipohypertrophy zones and reduction of needle re-use results in a significant reduction in severe hypoglycemic episodes, unexplained hypoglycemias and in the number of people with high glucose variability.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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