Insulin-induced lypodistrophy in hemodialyzed patients: a new challenge for nephrologists?

Publication date: Available online 14 November 2019Source: Diabetes &Metabolic Syndrome: Clinical Research &ReviewsAuthor(s): S. Gentile, F. Strollo, E. Satta, T. Della-Corte, C. Romano, G. Guarino, Nefrocenter Research Study Group: Nephrologists, Diabetologists, NursesSummaryDiabetes Mellitus (DM) is the most common cause of renal failure and ESRD all over the world, and often requires an individualized insulin treatment regimen. Malnutrition, depression-related eating behavior changes, high on-off-dialysis day-to-day glycemic variability and frequent hypoglycemic events occurring during or immediately after dialysis make it hard to identify best insulin dosage in hemodialyzed patients. This suggests a prudent attitude including non-stringent control, despite which repeated hypoglycemia quite often occurs in such patients. When looking for possible sources of hypoglycemia, health professionals too often overlook the identification of skin lipodystrophy (LD) due to an incorrect insulin injection technique. This mini-review focuses on the high frequency (57%) of LD in a cohort of 1004 insulin-treated people with DM on dialysis consecutively referring to our joint medical centers, and on its relationship with hypoglycemia and glycemic control/variability. When taking on such patients, care team members accept to face a complex disease burdened with several risk factors requiring high professional skills, and have to keep in mind also the possible presence of any LD area...
Source: Diabetes and Metabolic Syndrome: Clinical Research and Reviews - Category: Endocrinology Source Type: research

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Source: Journal of Cardiovascular Nursing - Category: Nursing Tags: ARTICLES: Cardiovascular Disease Source Type: research
Dexcom Learns a Valuable Lesson  A major server outage rattled Dexcom customers – particularly parents of diabetic children – over the U.S. Thanksgiving holiday weekend. But most were not as mad about the technology glitch as they were about the company's lack of communication about the issue. Dexcom has since fixed the problem and promised to communicate better with customers going forward.   Vicarious Surgical Scores Breakthrough Designation for Surgical Robot Vicarious Surgical is now the first to receive a breakthrough device designatio...
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Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
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Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
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Source: Journal of Clinical Gastroenterology - Category: Gastroenterology Tags: ALIMENTARY TRACT: Original Articles Source Type: research
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Source: Journal of Clinical Gastroenterology - Category: Gastroenterology Tags: LIVER, PANCREAS & BILIARY TRACT: Original Articles Source Type: research
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Source: European Review for Medical and Pharmacological Sciences - Category: Drugs & Pharmacology Tags: Eur Rev Med Pharmacol Sci Source Type: research
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