Evaluation of ultrasound examination combined with intensive injection technique education on insulin-induced lipohypertrophy (LH) management: a prospective cohort study in China

Aim This study was aimed to assess the impact of ultrasound examination combined with intensive injection technique education for LH management. Method A total of 120 patients with diabetes who were identified as existing clinical LH were enrolled into the study. All patients underwent ultrasound examination and received intensive injection technique education based on ultrasound detection results and Chinese guideline for diabetic injection technology in a prospective single study in China with a follow-up of 3 months. Injection Technique Questionnaire (ITQ) and assessment of glycemic control were used to assess the impact of ultrasound examination combined with intensive injection technique education for LH management. Results As expected, after 3 months of intensive injection technique education based on ultrasound examination, the proportion of patients who had mastered insulin injection technique was significantly increased ( p <0.05). The mean HbA1c was decreased by 0.60 (0.28)% from 7.61 (0.34)% to 7.01 (0.23)%, mean FBG was decreased by 1.20 (1.05) mmol/L from 8.10 (1.02) mmol/L to 6.90 (0.71) mmol/L, mean 2hPG was decreased by 1.70 (1.31) mmol/L from 11.49 (1.25) mmol/L to 9.79 (0.87) mmol/L without increasing the insulin dosage. The glycemic variability (GV) indicators (LAGE, MBG, SDBG, and PPGE), hypoglycemic, hyperglycemic, and IM injection events were markedly decreased ( p <0.05). Conclusions Ultrasound examination combined with intensive injection technique education markedly improved glycemic control in diabetes with LH without increasing the insulin dosage, as well as reducing the occurrence of adverse blood glucose events. It can be a new effective approach for LH management.