Hauner H, Stockamp B, Haastert B
Diabetes Research Institute, Heinrich-Heine-University Düsseldorf, Germany.
Exp Clin Endocrinol Diabetes. 1996;104(2):106-10. doi: 10.1055/s-0029-1211431.
In a cross-sectional study the frequency of insulin-induced lipohypertrophy at injection sites was assessed in 223 type 1 and 56 type 2 diabetic patients. 64 (28.7%) of the subjects with type 1 diabetes, but only 2 (3.6%) of those with type 2 diabetes presented clinical evidence of lipohypertrophy. In every second affected type 1 diabetic patient lipohypertrophy developed within 2 years after starting insulin therapy. The occurrence of lipohypertrophy was independent of the insulin source and mode of therapy. In a multivariate logistic regression analysis young age, low body mass index, abdominal injection site and, particularly, missing rotation of injection site were significant independent risk factors for the presence of insulin-induced lipohypertrophy. Avoidance of such areas led to a partial or full remission of tissue swellings in 6 of 11 cases under observation for one year. In conclusion, lipohypertrophy is still a frequent complication of insulin therapy. To prevent such local skin reactions insulin-treated patients should be more intensively trained to regularly change injection sites.
在一项横断面研究中，对223例1型糖尿病患者和56例2型糖尿病患者注射部位胰岛素诱导性脂肪增生的发生率进行了评估。1型糖尿病患者中有64例（28.7%）出现脂肪增生的临床证据，而2型糖尿病患者中仅有2例（3.6%）出现。每2例受影响的1型糖尿病患者中就有1例在开始胰岛素治疗后2年内出现脂肪增生。脂肪增生的发生与胰岛素来源和治疗方式无关。在多因素逻辑回归分析中，年轻、低体重指数、腹部注射部位，尤其是注射部位未轮换是胰岛素诱导性脂肪增生存在的显著独立危险因素。在为期一年的观察中，11例患者中有6例避免在这些部位注射后，组织肿胀部分或完全消退。总之，脂肪增生仍是胰岛素治疗常见的并发症。为预防此类局部皮肤反应，应对接受胰岛素治疗的患者加强培训，使其定期更换注射部位。
