Abstract

Introduction

Despite the availability of sophisticated devices and suitable recommendations on how to best perform insulin injections, lipohypertrophy (LH) and bruising (BR) frequently occur as a consequence of improper injection technique.

Aim

The purpose of this nationwide survey was to check literature-reported LH risk factors or consequences for any association with BR

Method

This was a cross-sectional, observational, multicenter study based on the identification of skin lesions at all patient-reported insulin injection sites in 790 subjects with diabetes. General and injection habit-related elements were investigated as possible BR risk factors.

Results

While confirming the close relationship existing between LH and a full series of factors including missed injection site rotation, needle reuse, long-standing insulin treatment, frequent hypoglycemic events (hypos), and great glycemic variability (GV), the observed data could find no such association with BR, which anyhow came with high HbA1c levels, missed injection site rotation, and long-standing insulin treatment.

Conclusion

BR most likely depends on the patient’s habit of pressing the injection pen hard onto the skin. Despite being worrisome and affecting quality of life, BR seems to represent a preliminary stage of LH but does not affect the rate of hypos and GV.

Trial Registration

207/19.09.2017

Details

Title
Bruising: A Neglected, Though Patient-Relevant Complication of Insulin Injections Coming to Light from a Real-Life Nationwide Survey
Author
Gentile, Sandro 1   VIAFID ORCID Logo  ; Guarino, Giuseppina 1 ; Della Corte, Teresa 1 ; Marino, Giampiero 1 ; Satta, Ersilia 2 ; Romano, Carmine 2 ; Alfrone, Carmelo 2 ; lmberti, Clelia 2 ; Strollo, Felice 3 ; Armentano, Vincenzo; Cucco, Lia; De-Rosa, Nicoletta; Gentile, Luigi; Giancaterini, Annalisa; Grassi, Giorgio; Lalli, Carlo; Lo-Grasso, Giovanni; Sudano, Maurizio; Tatti, Patrizio; Angioni, A.; Armentano, V.; Ballauri, C.; Botta, A.; Bova, A.; Calzolari, G.; Canu, L.; Capuano, G.; Caraffa, F.; Cavani, R.; Cavuto, L.; Cimitan, F.; Ciotola, M.; Clemente, G.; Colarusso, S.; Corsini, R.; Cristofanelli, L.; Cucco, L.; Del Buono, A.; De Rosa, N.; Di Blasi, V.; Di Levrano, G.; Di Loreto, C.; Felace, G.; Fiorentino, R.; Focardi, M.; Gaeta, I.; Gaiofatto, R.; Garrapa, G.; Gentile, L.; Guarino, G.; Guida, D.; Lai, M.; Lalli, C.; Landini, C.; Lucia, E.; Maino, S.; Manfrini, S.; Marcone, A. T. M.; Marino, C.; Marino, G.; Mazzocchi, L.; Merlini, A.; Miranda, C.; Moscatelli, C.; Musto, B.; Oliva, D.; Oliviero, B.; Pasquero, A.; Piastrella, L.; Pisanu, P.; Pollace, M.; Raffaele, A.; Ravera, M.; Russo, E.; Scarpitta, A.; Speese, K.; Strollo, F.; Sudano, M.; Tommasi, E.; Tonutti, L.; Turco, S.; Uberti, M.; Viberti, P.; Vinci, C.; Zambroni, M.; Zamparo, F.; Zenoni, L.; Zoffoli, M.; Corigliano, Gerardo; Corigliano, Marco; Improta, Maria Rosaria; Martino, Carmine; Fasolino, Antonio; Vetrano, Antonio; Vecchiato, Agostino; Oliva, Domenica; Lamberti, Clelia; Cozzolino, Domenico; Brancario, Clementina; Franco, Luca

1  Campania University “Luigi Vanvitelli”, Department of Internal Medicine, Naples, Italy (GRID:grid.9841.4) (ISNI:0000 0001 2200 8888); Nefrocenter Research Network & Nyx Start-Up, Naples, Italy (GRID:grid.9841.4) 
2  Nefrocenter Research Network & Nyx Start-Up, Naples, Italy (GRID:grid.9841.4) 
3  IRCCS San Raffaele Pisana, Endocrinology and Diabetes, Rome, Italy (GRID:grid.18887.3e) (ISNI:0000000417581884) 
Pages
1143-1157
Publication year
2021
Publication date
Apr 2021
Publisher
Springer Nature B.V.
ISSN
18696953
e-ISSN
18696961
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1007/s13300-021-01026-w
ProQuest document ID
2512389549
Copyright
© The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.