Insulin injection into lipohypertrophic tissue: Blunted and more variable insulin absorption and action and impaired postprandial glucose control

Diabetes Care

Volumn 39, Issue 9, 2016, Pages 1486-1492

  Famulla, Susanne ^a   Hovelmann, Ulrike ^a   Fischer, Annelie ^a   Coester, Hans Veit ^a   Hermanski, Lidia ^a   Kaltheuner, Matthias ^b   Kaltheuner, Lars ^b   Heinemann, Lutz ^a   Heise, Tim ^a   Hirsch, Laurence ^c  

^a Gemeinschaftspraxis Kaltheuner ^*  (Germany)

^b Gemeinschaftspraxis Kaltheuner v Boxberg   (Germany)

^c BD Technologies   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

GLUCOSE; INSULIN LISPRO; ANTIDIABETIC AGENT; GLUCOSE BLOOD LEVEL; INSULIN;

ADIPOSE TISSUE; ADULT; AREA UNDER THE CURVE; ARTICLE; CARBOHYDRATE INTAKE; CLINICAL ARTICLE; CONTROLLED STUDY; CROSSOVER PROCEDURE; DRUG ABSORPTION; DRUG EFFECT; ECHOGRAPHY; FEMALE; GLUCOSE BLOOD LEVEL; GLYCEMIC CONTROL; HUMAN; HYPERGLYCEMIA; HYPERINSULINEMIC-EUGLYCEMIC CLAMP TECHNIQUE; HYPOGLYCEMIA; INCIDENCE; INSULIN DEPENDENT DIABETES MELLITUS; LIPOHYPERTROPHY; MALE; MEAL; PHYSICAL EXAMINATION; RANDOMIZED CONTROLLED TRIAL; AGED; ANALYSIS; BLOOD; CHEMICALLY INDUCED; COMPLICATION; DIABETES MELLITUS, TYPE 1; DRUG EFFECTS; GLUCOSE CLAMP TECHNIQUE; LIPODYSTROPHY; METABOLISM; MIDDLE AGED; POSTPRANDIAL STATE; SUBCUTANEOUS DRUG ADMINISTRATION;

ADULT; AGED; BLOOD GLUCOSE; CROSS-OVER STUDIES; DIABETES MELLITUS, TYPE 1; FEMALE; GLUCOSE CLAMP TECHNIQUE; HUMANS; HYPERGLYCEMIA; HYPOGLYCEMIA; HYPOGLYCEMIC AGENTS; INJECTIONS, SUBCUTANEOUS; INSULIN; INSULIN LISPRO; LIPODYSTROPHY; MALE; MIDDLE AGED; POSTPRANDIAL PERIOD;

EID: 84986213814     PISSN: 01495992     EISSN: 19355548     Source Type: Journal    
DOI: 10.2337/dc16-0610     Document Type: Article

References (24)

1. Heinemann L. Insulin absorption from lipodystrophic areas: A (neglected) source of trouble for insulin therapy? J Diabetes Sci Technol 2010;4:750-753
2. Hauner H, Stockamp B, Haastert B. Prevalence of lipohypertrophy in insulin-treated diabetic patients and predisposing factors. Exp Clin Endocrinol Diabetes 1996;104:106-110
3. Seyoum B, Abdulkadir J. Systematic inspection of insulin injection sites for local complications related to incorrect injection technique. Trop Doct 1996;26:159-161
4. Blanco M, Hern ández MT, Strauss KW, Amaya M. Prevalence and risk factors of lipohypertrophy in insulin-injecting patients with diabetes. Diabetes Metab 2013;39:445-453
5. Vardar B, Kizilci S. Incidence of lipohypertrophy in diabetic patients and a study of influencing factors. Diabetes Res Clin Pract 2007;77: 231-236
6. Chowdhury TA, Escudier V. Poor glycaemic control caused by insulin induced lipohypertrophy. BMJ 2003;327:383-384
7. Overland J, Molyneaux L, Tewari S, et al. Lipohypertrophy: Does it matter in daily life? A study using a continuous glucose monitoring system. Diabetes Obes Metab 2009;11:460-463
8. Johansson UB, Amsberg S, Hannerz L, et al. Impaired absorption of insulin aspart from lipohypertrophic injection sites. Diabetes Care 2005;28:2025-2027
9. Heise T, Nosek L, Bøttcher SG, Hastrup H, Haahr H. Ultra-long-acting insulin degludec has a flat and stable glucose-lowering effect in type 2 diabetes. Diabetes Obes Metab 2012;14: 944-950
10. Heinemann L, Weyer C, Rauhaus M, Heinrichs S, Heise T. Variability of the metabolic effect of soluble insulin and the rapid-acting insulin analog insulin aspart. Diabetes Care 1998; 21:1910-1914
11. Becker RH,Nowotny I, Teichert L, Bergmann K, Kapitza C. Low within- and between-day variability in exposure to new insulin glargine 300 U/ml. Diabetes Obes Metab 2015;17:261-267
12. Young RJ, Hannan WJ, Frier BM, Steel JM, Duncan LJ. Diabetic lipohypertrophy delays insulin absorption. Diabetes Care 1984;7:479-480
13. Fujikura J, FujimotoM, Yasue S, et al. Insulininduced lipohypertrophy: Report of a case with histopathology. Endocr J 2005;52:623-628
14. Wallymahmed ME, Littler P, Clegg C, Haqqani MT,Macfarlane IA. Nodules of fibrocollagenous scar tissue induced by subcutaneous insulin injections: A cause of poor diabetic control. Postgrad Med J 2004;80:732-733
15. Grassi G, Scuntero P, Treppicioni R, Marubbi F, Strauss K.Optimizing insulin injection technique and its effect on blood glucose control. J Clin Transl Endocrinol 2014;1:145-150
16. Sun Z, Li Q, Ji L, et al. Lipohypertrophy: Prevalence, risk factors, clinical characteristics, and economic burden of insulin-requiring patients in China. Diabetologia 2015;58(Suppl. 1):S438-S439
17. Becker RHA. Pharmacodynamic evaluation: Diabetes methodologies. In Drug Discovery and Evaluation: Methods in Clinical Pharmacology. Vogel HG, Maas J, Gebauer A, Eds. Berlin, Heidelberg, Springer-Verlag, 2011, p. 457-481
18. Vora J,Heise T. Variability of glucose-lowering effect as a limiting factor in optimizing basal insulin therapy: A review. Diabetes Obes Metab 2013;15:701-712
19. Cox DJ, Gonder-Frederick L, Ritterband L, Clarke W, Kovatchev BP. Prediction of severe hypoglycemia. Diabetes Care 2007;30:1370-1373
20. McCall AL, Kovatchev BP. The median is not the only message: A clinician's perspective on mathematical analysis of glycemic variability and modeling in diabetes mellitus. J Diabetes Sci Technol 2009;3:3-11
21. Trayhurn P, Wood IS. Adipokines: Inflammation and the pleiotropic role ofwhite adipose tissue. Br J Nutr 2004;92:347-355
22. Spencer M, Unal R, Zhu B, et al. Adipose tissue extracellular matrix and vascular abnormalities in obesity and insulin resistance. J Clin Endocrinol Metab 2011;96:E1990-E1998
23. Pasarica M, Sereda OR, Redman LM, et al. Reduced adipose tissue oxygenation in human obesity: Evidence for rarefaction, macrophage chemotaxis, and inflammation without an angiogenic response. Diabetes 2009;58:718-725
24. Perciun R. Ultrasonographic aspect of subcutaneous tissue dystrophies as a result of insulin injections. Med Ultrason 2010;12: 104-109