2019 Volume 62 Issue 10 Pages 659-666
In some patients, diabetes treatment with subcutaneous injection can cause subcutaneous adipose tissue changes with or without palpable subcutaneous indurations. Those changes can subsequently lead to unstable glycemic control. We followed 44 patients who had their subcutaneous region injection sites examined for changes in the sonographic appearance and their glycemic control evaluated after the patients switched their injection sites. We divided the subcutaneous regions into three groups according to the sonographic appearance: hyperechoic regions as group H, mixed regions as group M and hypoechoic regions as group L. In group H, 40.7 % of regions were non-palpable. The average HbA1c levels were decreased at 2 and 12 months after the patients began avoiding injecting into their subcutaneous regions. We later re-examined the ultrasonography findings of 23 patients from group H, 9 from group M and 3 from group L. In 15 patients from group H and 5 from group M, the hyperechoic regions had vanished or improved 2-48 months after the patients began avoiding subcutaneous injection. However, we did not detect any marked improvement in group L. These findings suggest that the examination of subcutaneous regions by ultrasonography is useful for ensuring stable glycemic control even when palpable indurations cannot be detected.
