Gender Differences in Prevalence and Clinical Correlates of Lipohypertrophy in Insulin-Exposed Patients with Diabetes Mellitus

Abstract

Purpose

The purpose of this systematic review was to assess potential gender differences in prevalence and clinical relevance of insulin-related lipohypertrophy (LH).

Patients and Methods

Five electronic databases (PubMed, Embase, CNKI, Wanfang and VIP) were systematically searched for studies, from inception to 1st Sep 2022, on the prevalence of insulin-related LH. The eligibility of articles was independently screened, and the included studies were evaluated using standardized quality assessment tools.

Results

A total of 22 studies mentioned the LH prevalence in different genders, of which two are about gestational diabetes; therefore, 20 studies were eventually included, providing data on 6238 patients. The prevalence of LH varied from 30.26% to 72.54%. Ten studies (4392 patients) were conducted with the adult diabetes patients of different genders over the age of 18, the total prevalence rate of LH was 51.73%, the LH prevalence in male gender was from 41.94% to 68.57% and the rate of the total population was 54.89% (2046 patients); The LH prevalence in female gender was from 33.18% to 70% and the rate of the total population was 48.98% (2346 patients), and the prevalence of LH was significantly different between male and female gender (P<0.001). Interestingly, only one study (n=1227) showed that there were dramatic differences between different genders (P<0.001), the subjects were T2DM patients, the LH prevalence rate of male vs female was 70.52% (299/424) VS 52.18% (419/803), while the other studies either only include T1DM or both T1DM and T2DM.

Conclusion

The evidence shows that the results of gender differences in the LH prevalence are inconsistent with different types of DM. Probably, there is no gender differences in the LH prevalence in adult patients with T1DM, but it has a gender difference between male and female in T2DM. More strictly designed clinical studies are needed to further verify and reveal the underlying mechanisms.

Keywords:

• insulin injection
• lipohypertrophy
• gender differences
• hypertrophy
• diabetes mellitus
• prevalence

Acknowledgments

We are very grateful to all the participants of this study for their contributions to this research. Siping Peng, Mingming Xu, and Hengxia Zhao contributed equally to this manuscript.

Disclosure

The authors state that they have no conflicts of interest in this work.

Additional information

Funding

This study was supported by the Research Project of Traditional Chinese Medicine Bureau of Guangdong Province, China (No.20211324) and the “3030 PLAN” project of TCM clinical research of Shenzhen Traditional Chinese Medicine Hospital (G3030202123).