ESPE Abstracts

Abstract: 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). Many risk factors predispose to the occurrence of LD.

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) 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 and CSII (15 studies, n= 3208 children, and adolescents, 1449 had LD) was 45.16 %. In these studies. the prevalence of LD varied greatly between 17% and 62% and was significantly affected by different risk factors. These variabilities can partially be explained by the different risk factors. Important risk factors found in these studies included: the longer duration of diabetes, the reuse of insulin syringe > 5 times, lack of rotating insulin injection sites, using a small area for injection, higher insulin dose/kg, BMI, the location of injection (more LD in the abdomen), low level of patient education, higher insulin antibodies and poor control of diabetes. In addition, the method of detecting LD markedly affect the prevalence of LD, ultrasound detection increased markedly the diagnosis of LD in these patients compared to palpation and inspection.

Conclusions: The pooled prevalence of LD in children and adolescents with T1DM was still considerably high (45.16%). Education about proper injection technique and regular examination of injection sites remain a crucial part of diabetes management.