International Society for Pediatric and Adolescent Diabetes
ISPAD 2014 | 40th Anniversary |
247
P159
Epidemiology of lipohypertophy versus lipoatrophy among type1 diabetic school children in
Menofia, Egypt
M. Ayad
1
, A. Zaakouk
2
, M. El-Mougi
2
1
Al-Azhar University, Pediatrics, Menofia, Egypt,
2
Al-Azhar University, Pediatrics, Cairo, Egypt
Objectives:
Studying prevalence & incidence of lipohypertrophy and lipoatrophy among type 1
diabetic children in Menofia, and to investigate their distribution and associated factors.
Materials and methods:
A cross sectional study was done on diabetic school children (6-18 years)
(n=783) in Menofia from June till Dec 2013, all had been under treatment with human insulin at least
for three months, excluding those with other autoimmune diseases or HIV. First, anthropologic,
demographic and clinical features of patients were recorded in a questionnaire in which risk factors for
lipodystropy, regarding relevant literature, were investigated. Then all of them were examined clinically
for localized lipodystrophy by observation and palpation techniques. In all patients, glycosylated
hemoglobin (HbA
1C
) and Insulin antibodies (IA) were measured. Lipodystrophic patients were
classified as lipoatrophic or lipohypertrophic. Data then were statistically analyzed.
Results:
Prevalence of lipodystrophy, lipohypertrophy and lipoatrophy in our study was
(50.3%,47.6%and 2.7%) and incidence of these lesions during preceding 12 months
was(4.1%,3.8%and 0.3%) respectively. Lipohypertrophy occurred more among males, low social
standard patients and 12-18 years age group (p< 0.01). lipoatrophy occurred more in high social
standard patients(p< 0.01) without significant age and sex preference.
(Both lesions significantly were
related to longer diabetes duration (>10 years), higher HBA
1c
levels and usage of one needle more
than once. Lipohypertrophy significantly was associated with fixed sites of injection, more than 4 daily
injections and higher insulin dose/kg. lipoatrophy significantly was associated with higher IA levels,
usage of (Aspart/Lispro),pump infusion and lower BMI
) as descendingly arranged according to odds
ratio.
Conclusions:
Even with human insulin, frequency of the lipodystrophy particularly of lipohypertrophy
still remained high, preventable risk factors should be targeted.
