Determination of lipohypertrophy and lipoatrophy prevalence and associated risk factors in insulin-treated patients with TYPE 2 diabetes mellitus

This research was conducted with the aim of determining the prevalence of lipohypertrophy and lipoatrophy and associated risk factors in individuals diagnosed with Type 2 diabetes and treated with insulin. The data for this cross-sectional and descriptive research were collected between January 2022 and April 2022. The population of the research consisted of individuals diagnosed with type 2 diabetes and treated with insulin, applying to the endocrine and internal medicine outpatient clinics and wards and emergency services of Ankara City Hospital. A total of 271 individuals who fulfilled the inclusion criteria and agreed to participate in the research were chosen as the sample. The presence of lipoatrophy and lipohypertrophy was evaluated by inspection and palpation. The data were collected by the researcher through face-to-face interviews and using a questionnaire form. The questionnaire for data collection was prepared by the researchers in the light of the relevant literature. Chi-square analysis and Fisher Chi-square analysis were used for the evaluation of the data. The research results revealed that the prevalence of lipoatrophy was 4.8% (n:13) and the prevalence of lipohypertrophy was 19.2% (n:52). The lipohypertrophy detected in 12.5% of the individuals diagnosed with diabetes mellitus was found to be grade-1. It was also reported that 47.5% (n:29) of cases with lipohypertrophies and 84.6% (n:11) of cases with lipoatrophy were located in the abdomen. It was also found out that the factors affecting the development of lipoatrophy included hyperglycaemic attacks in the last 3 months, injection entry angle, choosing the arm as the injection spot, intra-site rotation and the frequency of changing the needle tip. The factors affecting the development of lipohypertrophy, on the other hand, were found to be age, gender, total daily insulin dose, number of daily injections, current insulin treatment, systematic and intra-site rotation status, HDL and triglyceride levels. Here we may conclude that lipodystrophies are observed frequently and may develop due to some modifiable risk factors. Therefore, in order to prevent the development of lipodystrophies that prevent safe insulin use, cause pain, poor appearance and changes in insulin absorption and to provide appropriate disease management, it is recommended that nurses examine individuals at regular intervals and are properly trained in this regard. Key Words: Diabetes, İnsulin Management, Lipoatrophy, Lipohypertrophy, Nursing