Lipohypertrophy: does it affect the control of diabetes in children?

ABSTRACT

The aim of this study was to find the prevalence of Lipohypertrophy [LH] in children with diabetes type 1, assess its effect on diabetes control and to study the parameters influencing its development. 119 children coming for regular follow up in the diabetes clinic were examined for the presence of LH by inspection and palpation. The last 4 readings of [Glycated hemoglobin] HbA1c levels and other factors that may affect LH e.g. duration of diabetes and the injection method were documented. The patient's age ranged from 2 months to 17 years with a median of 10 years. LH occurred in 54.9% of patients, more commonly in males [62.7%] vs. females [48.4%] [P= 0.074]. Grade 1 LH occurred in 42.5% and grade 2 in 12.4%. LH was related Significantly to the dose of insulin units per kg of body weight [F=5.741, P= .004], the duration of diabetes, [F=5.097, P=0.008.], adjusted body mass index [8MI] [X[2] = 20.024, P=0.003] and the injection method [X[2]=9.619, P= 0. 043]. HbA1c levels of patients with grade 1 and grade 2 LH did not differ from diabetics without LH [F =0.178, P=0.837]. In Children with LH need higher doses of insulin to achieve fair control compared to children without LH. The presence of LH was significantly related to the duration of diabetes, dose of insulin/ kg of body weight, the body mass index and the injection method. Further studies are needed to ascertain the clinical meaning of these findings: