Integrated Approach to Cardio-Vascular Risk in Insulin-Treated People with Diabetes based on the "Heart Project" and on Metabolic Complications Expected from Incorrect Injection Practice-Related Lipohypertrophy

Authors

  • Sandro Gentile Nefrocenter Research s.c. ar. l and Nyx Start-Up, Naples, Italy Author
  • Rossella Lamberti Metelliano Medical Center, Nefrocenter Network, Naples, Italy Author
  • Fabrizio Loiacono Nefrocenter Research s.c. ar. l, Naples, Italy Author
  • Carmelo Alfarone Nefrocenter Research s.c. ar. l and Nyx Start-Up, Naples, Italy Author
  • Maria Pasquarella Nefrocenter Research s.c. ar. l and Nyx Start-Up, Naples, Italy Author
  • Giampiero Marino Department of Internal Medicine, Campania University ‘‘Luigi Vanvitelli’’, Naples, Italy Author
  • Carmine Romano Nefrocenter Research s.c. ar. l and Nyx Start-Up, Naples, Italy Author
  • Teresa Della Corte Department of Internal Medicine, Campania University ‘‘Luigi Vanvitelli’’, Naples, Italy Author
  • Teresa Della Corte Nefrocenter Research s.c. ar. l and Nyx Start-Up, Naples, Italy Author
  • Giuseppina Guarino Department of Internal Medicine, Campania University ‘‘Luigi Vanvitelli’’, Naples, Italy Author
  • Giuseppina Guarino Nefrocenter Research s.c. ar. l and Nyx Start-Up, Naples, Italy Author
  • Maurizio Capece Vomero Center Crisci Bersabea & C S.N.C., Nefrocenter Network, Naples, Italy Author
  • Ersilia Satta Emodial Center s.r.l. Nefrocenter Network, Naples, Italy Author
  • Ersilia Satta Polispecialistic Nephrological Center CNP Srl, Nefrocenter Network srl. Frattamaggiore, Italy Author
  • Ersilia Satta Nefrocenter Research s.c. ar. l and Nyx Start-Up, Naples, Italy Author
  • Sandro Gentile Department of Internal Medicine, Campania University ‘‘Luigi Vanvitelli’’, Naples, Italy Author
  • Felice Strollo Endocrinology and Diabetes, IRCCS San Raffaele Pisana, Rome, Italy Author

DOI:

https://doi.org/10.47363/JDRR/2021(3)126

Keywords:

Insulin-Treated People, Diabetes, Metabolic Complications, Lipohypertrophy

Abstract

Type 2 diabetes (T2DM) is known to be associated with increased cardiovascular (CV) morbidity and mortality. Over time, the CV Risk of patients with T2DM has been assessed according to various methods, often borrowed from different populations. Nevertheless, never have been evaluated changes in insulin absorption due to improper injection technique and responsible for further, well recognized CV-R factors as high glycemic variability, frequent hypoglycemia, and unsatisfactory glycemic control. Aim of the study was to intensify diabetes and its own comorbidities treatment, and in addition reduce the impact of injection technique of insulin to evaluate possible improvement in the CV-R score and NHYA score in 4499 insulin-treated T2DM subjects with (LH+) and without lipohypertrophy (LH-) due to improper injection habit. The educational training and the treatment intensification significantly
reduced glycemic control, hypoglycemia rate and the mean amplitude of glycemic variability, especially in LH+ subjects, adding new knowledge to a global intervention addressed to reduce the devastating impact to the increased cardiovascular risk of diabetic people, inclusive of the risk due to LHs.

Author Biographies

  • Sandro Gentile , Nefrocenter Research s.c. ar. l and Nyx Start-Up, Naples, Italy

    Nefrocenter Research s.c. ar. l and Nyx Start-Up, Naples, Italy

  • Rossella Lamberti, Metelliano Medical Center, Nefrocenter Network, Naples, Italy

    Metelliano Medical Center, Nefrocenter Network, Naples, Italy

  • Fabrizio Loiacono, Nefrocenter Research s.c. ar. l, Naples, Italy

    Nefrocenter Research s.c. ar. l, Naples, Italy

  • Carmelo Alfarone, Nefrocenter Research s.c. ar. l and Nyx Start-Up, Naples, Italy

    Nefrocenter Research s.c. ar. l and Nyx Start-Up, Naples, Italy

  • Maria Pasquarella, Nefrocenter Research s.c. ar. l and Nyx Start-Up, Naples, Italy

    Nefrocenter Research s.c. ar. l and Nyx Start-Up, Naples, Italy

  • Giampiero Marino, Department of Internal Medicine, Campania University ‘‘Luigi Vanvitelli’’, Naples, Italy

    Department of Internal Medicine, Campania University ‘‘Luigi Vanvitelli’’, Naples, Italy

  • Carmine Romano, Nefrocenter Research s.c. ar. l and Nyx Start-Up, Naples, Italy

    Nefrocenter Research s.c. ar. l and Nyx Start-Up, Naples, Italy

  • Teresa Della Corte, Department of Internal Medicine, Campania University ‘‘Luigi Vanvitelli’’, Naples, Italy

    Department of Internal Medicine, Campania University ‘‘Luigi Vanvitelli’’, Naples, Italy

  • Teresa Della Corte, Nefrocenter Research s.c. ar. l and Nyx Start-Up, Naples, Italy

    Nefrocenter Research s.c. ar. l and Nyx Start-Up, Naples, Italy

  • Giuseppina Guarino, Department of Internal Medicine, Campania University ‘‘Luigi Vanvitelli’’, Naples, Italy

    Department of Internal Medicine, Campania University ‘‘Luigi Vanvitelli’’, Naples, Italy

  • Giuseppina Guarino, Nefrocenter Research s.c. ar. l and Nyx Start-Up, Naples, Italy

    Nefrocenter Research s.c. ar. l and Nyx Start-Up, Naples, Italy

  • Maurizio Capece, Vomero Center Crisci Bersabea & C S.N.C., Nefrocenter Network, Naples, Italy

    Vomero Center Crisci Bersabea & C S.N.C., Nefrocenter Network, Naples, Italy

  • Ersilia Satta, Emodial Center s.r.l. Nefrocenter Network, Naples, Italy

    Emodial Center s.r.l. Nefrocenter Network, Naples, Italy

  • Ersilia Satta, Polispecialistic Nephrological Center CNP Srl, Nefrocenter Network srl. Frattamaggiore, Italy

    Polispecialistic Nephrological Center CNP Srl, Nefrocenter Network srl. Frattamaggiore, Italy

  • Ersilia Satta, Nefrocenter Research s.c. ar. l and Nyx Start-Up, Naples, Italy

    Nefrocenter Research s.c. ar. l and Nyx Start-Up, Naples, Italy

  • Sandro Gentile , Department of Internal Medicine, Campania University ‘‘Luigi Vanvitelli’’, Naples, Italy

    Department of Internal Medicine, Campania University ‘‘Luigi Vanvitelli’’, Naples, Italy

  • Felice Strollo, Endocrinology and Diabetes, IRCCS San Raffaele Pisana, Rome, Italy

    Endocrinology and Diabetes, IRCCS San Raffaele Pisana, Rome, Italy

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Published

2021-07-25

Issue

Vol. 3 No. 3 (2021): Volume 3 Issue 3

Section

Articles