The Magnitude and Associated Risk factors of Lipodystrophy among Type 1 DM Children and Adolescents on follow up at Black Lion Hospital Pediatric Endocrinology Unit
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Date
2025-04-04
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Addis Ababa University
Abstract
Background- Type 1 diabetes(T1DM) is chronic autoimmune disease that results from the progressive destruction of pancreatic beta cells, insulin deprivation and therefore, the patients require insulin therapy throughout their lives. Lipodystrophy is a common side effect of insulin use in T1DM patients, characterized by changes in distribution and volume of subcutaneous fat stores. Lipodystrophy therefore can also be lipohypertrophy experienced when fat starts accumulated at the areas where one applies insulin and lipoatrophy which is actually experienced when one loses his or her fat tissue. Severe clinical consequences may include insulin resistance in case of Lipodystrophy, episodes of poor glycemic control and worsened diabetes complications. Research recognizes the lipodystrophy’s prevalence among T1DM patients to be 28-66%. Potential risk factors associated with lipodystrophy include duration of the diabetes, insulin use and incorrect method of insulin administration. Nevertheless, lipodystrophy epidemiology and risk factors in T1DM individuals can differ depending on geographical location and some settings.
Objective- The primary objective of this cross-sectional study is to determine the magnitude and risk factor of lipodystrophy, including both lipoatrophy and lipohypertrophy, among T1DM patients under 18 years of age receiving insulin therapy through subcutaneous injections with follow up at Black Lion Specialized Teaching Hospital Pediatric Endocrine clinic.
Methodology- A cross-sectional study will be conducted among Type 1 DM patients visiting pediatrics endocrine unit from Aug 2024 to Sep 2024. The data will be collected by trained interns with face to face interview by using pretested questioner. Data will be entered using Epi data version 3.5.1 and will be analyzed by SPSS version 26.0 and frequencies and percentages will be calculated to all variables. Binary Logistic regression was used to analyze the data.
Results: The study involved 140 participants, including 13 children (9.3%) under 5 years old, 30 (21.4%) aged 6 to 10, and 97 (69.3%) who were older than 11. There were 63 females (45.0%) and 77 males (55.0%), showing a slightly higher number of males in the group. The average BMI of the children was 20.5 ± 6 kg/m². On average, the participants had been living with Type 1 Diabetes for 6.71 years, with 93.6% using a mixed insulin regimen (NPH + Regular Insulin) and 6.4% on a Basal-Bolus regimen (Glargine + Regular Insulin). On the same token , 39 participants (27.9%) selected the thigh and arm as their preferred injection sites, while only 6 5 (4.3%) selected the abdomen. Of the participants, 43 (30.7%) did not rotate their injection sites on a regular basis, whereas 97 (69.3%) did. Lipodystrophy was more common in children with diabetes for more than five years (53 cases) than in those with less than five years (33 cases), according to the study.
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Risk factors of Lipodystrophy