Lipohypertrophic Skin Changes in Patients With Diabetes: Visualization by Infrared Images

Background: Many patients with diabetes on insulin therapy develop lipohypertrophies (LHTs). So far, LHTs are diagnosed by conventional methods (CM; visual inspection, palpation and/or ultrasound). In everyday life, it would be advantageous to have a quick, simple and inexpensive alternative, for example, diagnosing them by obtaining infrared (IR) images. Methods: We obtained IR images from 43 subjects (21 patients with type 1 diabetes, conventional subcutaneous insulin therapy and known LHTs, 8 patients with CSII and LHTs, 7 patients without LHTs, and 7 healthy people), all from one specialized diabetes practice. The IR images were taken under standardized conditions with a high-resolution infrared camera (VarioCam® HDx Jenoptic, IR pixel 640 × 480, thermal resolution 0.003K) and compared with LHT diagnoses with CM. Results: In 14 of the 29 (48%) patients, CM diagnosed LHTs were “cold spots” in the IR images. The temperature difference to “healthy” skin (without LHTs) was up to 6°C. Of the 14 patients, 11 also showed such spots, without findings with CM. Four patients did not show clearly identifiable cold spots as LHT and 2 patients showed no changes in the IR images. The remaining 9 patients did not show clearly identifiable cold spots as LHT, but the diagnosis with CM was also ambiguous. Conclusions: The results of this small (pilot) study do not clearly support the value of IR images for the diagnosis of LHTs, but they do not refute this approach. Diagnosis of LHT might be hampered due to the existence of different types of LHTs. Usage of IR images can apparently detect LHTs before they can be diagnosed with CM. Further targeted investigations are required to make statements about the usability of this method.

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Review of Insulin Therapy

Journal of Pharmacy Practice ◽

10.1177/0897190003261304 ◽

2004 ◽

Vol 17 (1) ◽

pp. 10-19 ◽

Cited By ~ 8

Author(s):

Kimberly K. Daugherty

Keyword(s):

Insulin Therapy ◽

Insulin Regimen ◽

Medline Search ◽

Different Types ◽

Dosing Regimens ◽

Long Acting ◽

Product Package ◽

Diabetes Patients

The objective of this article is to review the different types of insulin and to explain some of the different dosing regimens that are used. Articles were obtained via a MEDLINE search and product package inserts. There is no one insulin therapy that is best for all patients. Type 1 diabetes patients require insulin therapy tomaintain life. Studies support intensive insulin dosing in these patients to obtain an A1C of less than 7.0%. Insulin therapy for type 2 diabetes patients may be a little less clear. Long-acting insulin in combination with an oral agentmay be just as effective as insulin alone, and in patients who fail oral therapy, a simple insulin regimen is preferred over a complex one.

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Different modes of insulin therapy in patients with diabetes mellitus type 1 after kidney transplantation

10.26226/morressier.5d9b6233ea541d6ca8494248 ◽

2019 ◽

Author(s):

Inna Klefortova

Keyword(s):

Diabetes Mellitus ◽

Kidney Transplantation ◽

Insulin Therapy ◽

Diabetes Mellitus Type 1 ◽

Diabetes Mellitus Type ◽

Patients With Diabetes

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Features of carbohydrate metabolism in a patient with type 1 diabetes mellitus in subclinical hypothyroidism in the outcome of chronic autoimmune thyroiditis

Clinical and experimental thyroidology ◽

10.14341/ket9748 ◽

2019 ◽

Vol 14 (4) ◽

pp. 206-209

Author(s):

Margarita S. Mikhina ◽

Ekaterina A. Troshina ◽

Tatiana V. Nikonova

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Insulin Therapy ◽

Type 1 Diabetes Mellitus ◽

Carbohydrate Metabolism ◽

Autoimmune Thyroiditis ◽

Subclinical Hypothyroidism ◽

Chronic Autoimmune Thyroiditis ◽

Patients With Diabetes

Diabetes mellitus and primary hypothyroidism, in the outcome of chronic autoimmune thyroiditis, the two most common diseases in endocrinology and the practicing doctor are important not to forget about the possible association of these pathologies. This applies to patients with diabetes mellitus, both 1 and 2 types. However, the combination of these two pathologies is more common in type 1 diabetes, which is due to the autoimmune nature of these diseases. A clinical case of a patient with type 1 diabetes mellitus, which is on pump insulin therapy, is presented, which, in the background of previously selected therapy, during the last 2 months, episodes of hypoglycemia increased. In the course of the survey, primary subclinical hypothyroidism was identified, in the outcome of chronic autoimmune thyroiditis. Against the background of the achievement of euthyroidism, it was possible to achieve compensation of carbohydrate metabolism without correction of previously selected insulin therapy. The high incidence of thyroid dysfunction in patients with diabetes mellitus, and as a consequence, the deterioration in the compensation of carbohydrate metabolism, requires a systematic screening of thyroid disorders in the presence of diabetes mellitus.

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Evaluation of Meal Carbohydrate Counting Errors in Patients with Type 1 Diabetes

Experimental and Clinical Endocrinology & Diabetes ◽

10.1055/a-1493-2324 ◽

2021 ◽

Author(s):

Sina Buck ◽

Collin Krauss ◽

Delia Waldenmaier ◽

Christina Liebing ◽

Nina Jendrike ◽

...

Keyword(s):

Type 1 Diabetes ◽

Insulin Therapy ◽

Standardized Test ◽

Carbohydrate Content ◽

Estimation Accuracy ◽

Carbohydrate Counting ◽

Counting Error ◽

Patients With Diabetes ◽

Correct Estimation

Abstract Aim Correct estimation of meal carbohydrate content is a prerequisite for successful intensified insulin therapy in patients with diabetes. In this survey, the counting error in adult patients with type 1 diabetes was investigated. Methods Seventy-four patients with type 1 diabetes estimated the carbohydrate content of 24 standardized test meals. The test meals were categorized into 1 of 3 groups with different carbohydrate content: low, medium, and high. Estimation results were compared with the meals’ actual carbohydrate content as determined by calculation based on weighing. A subgroup of the participants estimated the test meals for a second (n=35) and a third time (n=22) with a mean period of 11 months between the estimations. Results During the first estimation, the carbohydrate content was underestimated by −28% (−50, 0) of the actual carbohydrate content. Particularly meals with high mean carbohydrate content were underestimated by −34% (−56, −13). Median counting error improved significantly when estimations were performed for a second time (p<0.001). Conclusions Participants generally underestimated the carbohydrate content of the test meals, especially in meals with higher carbohydrate content. Repetition of estimation resulted in significant improvements in estimation accuracy and is important for the maintenance of correct carbohydrate estimations. The ability to estimate the carbohydrate content of a meal should be checked and trained regularly in patients with diabetes.

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