ESPE Abstracts

Lipohypertrophy (LD) represents the most common cutaneous complication of insulin therapy worldwide. Epidemiological and clinical data on LD in children and adolescents with T1DM are growing since 2010 because of the introduction of new insulin analogs and the use of insulin pumps (CSII).

Objectives and Methods: We performed an electronic search in PubMed, Google scholar and Web of Sciences to evaluate the global prevalence and possible risk factors of LD in children and adolescents (2 -18 years) and adults (>18 years) on insulin therapy in all publications in the past 15 years.

Results: For children, 15 studies were included from 11 countries (Italy, India, Turkey, UAE, Saudi Arabia, Egypt, Canada, The Netherland, Iran, Austria and Ethiopia) after 2010. The pooled prevalence of the studies using MDII (15 studies, n= 2963 children, and adolescents, 1342 had LD) was 45.3 %. In these studies. the prevalence of LD varied greatly between 17% and 62% and was significantly affected by different risk factors. In three studies on children <18 years using CSII, (n= 423, from Italy, Canada, UAE, and Austria) the prevalence of LD was 47%, 42%, 36% and 46% respectively with pooled prevalence = 44.9%. This was not different compared to the pooled prevalence of patients using MDIT (45.3%). For Adults on insulin therapy 10 studies including metanalysis and multi-country studies (n= 48992, using MDIT and pens, 20239 had LD) the prevalence of LD = 41.3%. The prevalence of LD is significantly higher in children versus adults (z is -4.27, p <. 00001 In conclusion, it appears that in children with T1DM, the use of CSII did not change the prevalence of LD. However, the prevalence of LD is slightly higher in children versus adults on insulin therapy.