Original Article
Clinical application of high-frequency ultrasound in the screening of lipohypertrophy in diabetic patients
Zhu Min, Wang Hong, Shen Min, Yu Jian, Yan Dan, Luo Dan, Shi Yun, Hang Jing, Xu Jingjing, Yang Tao
Published 2021-08-27
Cite as Chin J Diabetes Mellitus, 2021, 13(8): 809-813. DOI: 10.3760/cma.j.cn115791-20201209-00706
Abstract
ObjectiveTo explore the clinical application of high-frequency ultrasound in the screening of lipohypertrophy (LH).
MethodsThis was a cross-section study. A total of 548 diabetic patients who received insulin injection more than six months were recruited from November 2016 to September 2020 in the First Affiliated Hospital of Nanjing Medical University. Clinical data and insulin injection duration of patients were collected, the patients were examined through visual and palpation and ultrasound. The t-test, nonparametric test or Chi square test was used to compare the count data between groups.
ResultsOf the 548 patients, 418 patients were found to have LH detected by clinical examination, 478 patients by ultrasound, 390 patients both by clinical examination and ultrasound. The detectable rate of LH by high-frequency ultrasound was higher than that by the clinical examination [76.3% (418/548) vs. 87.2% (478/548), χ2=59.998, P<0.01]. Compared with those detected by ultrasound only, the mean depth, median length, median width and median area of LH detected both by clinical examination and ultrasound examination were higher, with a statistically significant difference in the width diameter (P<0.05). The imaging features of LH included three types ( hyperechoic, isoechoic, hypoechoic) and five subtypes. Among them, the most common type was hyperechoic type, which had no blood flow, no capsule, and uniform mass with unclear boundary, accounting for 65.9% (315/478). Compared with LH detected by high-ultrasound only, the mean deep diameter, length diameter, width diameter and area of LH detected both by clinical examination and ultrasound examination were all increased, and the difference of width diameter was statistically significant [8.67 (7.66, 13.21) mm vs. 13.47 (8.70, 18.22) mm,Z=-2.135, P<0.05].
ConclusionIn addition to the traditional clinical examination (visualization and palpation), high-frequency ultrasound can be used as an important supplement to the examination of insulin injection site in diabatic patients.
Key words:
Diabetes mellitus; Ultrasonography; Insulin injection; Lipohypertrophy
Contributor Information
Zhu Min
Department of Endocrinology and Metabolism, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Wang Hong
Department of Endocrinology and Metabolism, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Shen Min
Department of Endocrinology and Metabolism, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Yu Jian
Department of Endocrinology and Metabolism, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Yan Dan
Department of Endocrinology and Metabolism, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Luo Dan
School of Nursing, Nanjing Medical University, Nanjing 211166, China
Shi Yun
Department of Endocrinology and Metabolism, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Hang Jing
Department of Ultrasound, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Xu Jingjing
Department of Endocrinology and Metabolism, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Yang Tao
Department of Endocrinology and Metabolism, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
