J E Kapeluto1, B W Paty1, S D Chang2, G S Meneilly3. 1. Division of Endocrinology, Department of Medicine, Vancouver General Hospital and University of British Columbia, Vancouver, Canada. 2. Department of Radiology, Vancouver General Hospital and University of British Columbia, Vancouver, Canada. 3. Division of Geriatric Medicine, Department of Medicine, Vancouver General Hospital and University of British Columbia, Vancouver, Canada.
Abstract
AIMS: To define standard criteria for the detection of lipohypertrophy using ultrasonography and to determine the accuracy of this method. METHOD: Individuals using insulin therapy for ≥2 years with unknown lipohypertrophy status were enrolled at a diabetes education centre. A team of diabetes educator nurses performed a clinical examination for evidence of lipohypertrophy and a separate team of ultrasonographers examined participants in a blinded fashion. RESULTS: The echo signature for lipohypertrophy consisted of location in the subcutaneous layer and lesions that were 1) well circumscribed either by hyperechoic foci with defined borders or a nodular shape with a hypoechoic halo, 2) heterogeneous in echotexture compared with surrounding tissue, 3) associated with distortion of surrounding connective tissue with 4) absence of vascularity and 5) absence of capsule. Ultrasonography identified individuals with lipohypertrophy significantly more frequently than inspection or palpation (P<0.0001). Inter-observer agreement was moderate (κ=0.50) and limited by the presence of subclinical lesions in 73% of the participants. CONCLUSIONS: The ultrasound detection of lipohypertrophy is consistent with clinical examination and is reproducible using a defined echo signature. (ClinicalTrials.gov registration no: NCT02348099).
AIMS: To define standard criteria for the detection of lipohypertrophy using ultrasonography and to determine the accuracy of this method. METHOD: Individuals using insulin therapy for ≥2 years with unknown lipohypertrophy status were enrolled at a diabetes education centre. A team of diabetes educator nurses performed a clinical examination for evidence of lipohypertrophy and a separate team of ultrasonographers examined participants in a blinded fashion. RESULTS: The echo signature for lipohypertrophy consisted of location in the subcutaneous layer and lesions that were 1) well circumscribed either by hyperechoic foci with defined borders or a nodular shape with a hypoechoic halo, 2) heterogeneous in echotexture compared with surrounding tissue, 3) associated with distortion of surrounding connective tissue with 4) absence of vascularity and 5) absence of capsule. Ultrasonography identified individuals with lipohypertrophy significantly more frequently than inspection or palpation (P<0.0001). Inter-observer agreement was moderate (κ=0.50) and limited by the presence of subclinical lesions in 73% of the participants. CONCLUSIONS: The ultrasound detection of lipohypertrophy is consistent with clinical examination and is reproducible using a defined echo signature. (ClinicalTrials.gov registration no: NCT02348099).
Authors: Rabab Hashem; Henrietta Mulnier; Haya Abu Ghazaleh; Susan Halson-Brown; Maria Duaso; Rebecca Rogers; Janaka Karalliedde; Angus Forbes Journal: BMJ Open Diabetes Res Care Date: 2021-12
Authors: Damian Ucieklak; Sandra Mrozinska; Aleksandra Wojnarska; Maciej T Malecki; Tomasz Klupa; Bartłomiej Matejko Journal: Int J Endocrinol Date: 2022-01-24 Impact factor: 3.257