The impact of insulin induced lipohypertrophy on carotid intima-media thickness in patients with type 2 diabetes mellitus

Medicine (Baltimore). 2023 Sep 29;102(39):e34696. doi: 10.1097/MD.0000000000034696.

Abstract

Lipohypertrophy (LH) is a major localized complication of insulin therapy. We aimed to investigate the association between insulin-induced LH and carotid intima-media thickness (CIMT) in patients with type 2 diabetes mellitus (DM). A total of 75 patients with DM treated with insulin were included in this study. The insulin injection sites of the patients were evaluated by inspection and palpation and then radiologically with ultrasound. The CIMT of the patients was evaluated using ultrasonography. According to the guideline recommendation, the CIMT cutoff value was taken as 0.9 mm, and the patients were categorized into 2 groups according to the CIMT value and evaluated statistically. The presence of LH (CI: 1.379-30.000; OR = 6.432; P < .05), age (CI: 1.036-1.149; OR = 1091; P < .05), BMI (CI: 1.003-1.262; OR = 1.125; P < .05) and duration of DM (CI: 1.001-1.300; OR = 1.141; P < .05) were independent risk factors for high-CIMT in patients with DM. The most interesting result of this study was that the presence of LH was an independent risk factor for increased CIMT. According to this result, we think that LH may increase the risk of cardiovascular disease as well as being a complication that disrupts the blood glucose regulation of patients with DM and increases the cost of treatment.

MeSH terms

  • Carotid Intima-Media Thickness
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Humans
  • Insulin / adverse effects
  • Risk Factors
  • Ultrasonography

Substances

  • Insulin