Original Article
Status of insulin injection behavior in elderly patients with type 2 diabetes and its effects on insulin injection induced lipohypertrophy
Jian Yu, Hong Wang, Meijing Zhou, Min Zhu, Yun Shi, Jing Hang, Jingjing Xu, Tao Yang
Published 2023-08-20
Cite as Chin J Diabetes Mellitus, 2023, 15(8): 714-719. DOI: 10.3760/cma.j.cn115791-20230215-00058
Abstract
ObjectiveTo investigate the status of insulin injection behavior in elderly patients with type 2 diabetes mellitus (T2DM) and its effect on lipohypertrophy (LH).
MethodsFrom January 2021 to July 2022, 196 elderly patients with T2DM who had been receiving insulin injection continuously for more than 6 months in the Department of Endocrinology of the First Affiliated Hospital of Nanjing Medical University were selected. The patients′ age, gender, daily storage method of insulin, injection sites rotation method, duration of insulin injection, total amount of daily insulin injection, number of daily injection needles, and whether the needles were reused, were collected. According to the results of ultrasound scanning, patients were divided into non-LH group and LH group. The t test, Mann-Whitney U test or χ2 test were used for comparison between groups, and binary logistic regression analysis was used to analyze the influencing factors of LH.
ResultsA total of 196 patients were included. There were 100 males and 96 females; 35 cases without LH and 161 cases with LH. In 44.90% (88/196) of the patients, the insulin pen for daily injection was incorrectly kept in the refrigerator, 83.67% (164/196) reused needles, the correct intra-site rotation rate of patients was only 24.49% (48/196), and 81.63% (160/196) of patients only injected insulin in the abdomen. The incidence of LH diagnosed by ultrasound was as high as 82.14% (161/196). Compared with the non-LH group, the duration of insulin injection in the LH group was longer, the total amount of daily insulin injection was greater, more injections per day, needle reuse and daily storage of insulin in the refrigerator were more frequent, and the rotation rate within and between the correct sites was lower (all P<0.05). Binary logistic regression analysis showed that the storage mode of insulin in use (OR=3.550, 95%CI 1.366-9.224, P=0.009), needle reuse (OR=4.824, 95%CI 1.992-11.684, P<0.001) and total insulin dosage per day (OR=1.051, 95%CI 1.014-1.089, P=0.006) were independent risk factors for LH.
ConclusionsNon-standard insulin injection behavior is common in elderly patients with T2DM, and it will affect the occurrence of LH.
Key words:
Diabetes mellitus, type 2; Insulin injection; Lipohypertrophy; Elderly
Contributor Information
Jian Yu
Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Hong Wang
Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Meijing Zhou
Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Min Zhu
Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Yun Shi
Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Jing Hang
Department of Ultrasound Diagnosis, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Jingjing Xu
Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Tao Yang
Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
