Factors related to subcutaneous fat hyperplasia caused by insulin injection:a Meta-analysis

ZHANG Qin; JIA Ping; WANG Li; XIAO Li; LI Xinyu

doi:10.12102/j.issn.2095-8668.2023.24.006

Abstract：Objective:To systematically evaluate the relevant risk factors of subcutaneous fat hyperplasia caused by insulin injection,and provide evidence-based basis for clinical intervention.Methods:Computer search publicly published cohort studies,case-control studies,and cross-sectional studies on the factors related to subcutaneous adipose hyperplasia caused by insulin injection was conducted on CNKI,WanFang Database,CBM,PubMed,the Cochrane Library,EMbase,and Web of Science.The retrieval time was from the inception to April 30,2022.Apply Stata 16.0 software for Meta-analysis.Results:A total of 20 studies were included,with 7 217 patients.Meta-analysis results showed that the injection site(OR=2.90,95％CI 2.12-3.99),needle reuse(OR=1.15,95％CI 1.02-1.29),reuse times＞5(OR=2.38,95％CI 1.79-3.17),increased body mass index(WWMD=0.78,95％CI 0.05-1.51),diabetes course(WMD=1.69,95％CI 0.01-3.37),increased years of insulin injection(WMD=1.12,95％CI 0.51-1.73),and high daily insulin dose(WMD=4.89,95％CI 2.60-7.17),needle length≥8 mm(OR=1.34,95％CI 1.01-1.78),small injection area(OR=1.21,95％CI 1.01-1.46),and insulin treatment regimen(OR=1.75,95％CI 1.38-2.22)are related factors for subcutaneous fat hyperplasia after insulin injection.Conclusion:Current evidence suggests that medical personnel should provide targeted education and strengthen it for patients,especially for older insulin injection patients,who should be guided to rotate the injection site correctly and single-use injection needles;secondly,for high-risk patients with high body mass index,long duration of insulin injection,and high daily total dose of insulin injection,regular evaluation and examination of the skin condition in the injection area should be conducted,and timely intervention and treatment should be carried out.