Prevalence of lipohypertrophy in insulin‐treated diabetes patients: A systematic review and meta‐analysis

Abstract

Insulin-treated diabetic patients are at high risk for lipohypertrophy (LH), but this clinical problem has been overlooked by some medical staff. In addition, studies differed with each other significantly in prevalence of LH. This systematic review aimed to determine pooled prevalence levels of LH among insulin injection diabetics. Four electronic databases (PubMed, EMBASE, The Cochrane Library and Scopus) were searched for eligible studies from their inception until April 2017 and reference lists were searched manually to identify additional studies. Studies containing data on LH in patients with diabetes mellitus (DM) were included. Meta-analysis was conducted with random-effect model. 26 studies reported with a total of 12493 participants met the inclusion criteria. Meta-analysis revealed that the pooled prevalence of LH was 38% (95% CI, 29%–46%, I² = 99.1%). The main influence on LH was type of DM. The pooled prevalence of LH among patients with type 2 diabetes mellitus (T2DM) was higher than patients with type 1 diabetes mellitus (T1DM) [49% (95% CI, 23%–74%) vs 34% (95% CI, 19%–49%)]. The pooled prevalence of LH among patients with a mixed type of DM was 37% (95% CI, 25%–48%, I² = 98.3%). The prevalence of LH was high in insulin-treated diabetic patients. It demonstrated that diabetes nurses should screen for LH regularly in their patients, and teach them how to prevent LH in their daily management of DM.