Comparison of ultrasound scanning and clinical examination for detecting insulin injection related Lipohypertrophy and construction of Lipohypertrophy classification table.

Aims: To explore an cost-effective, convenient method for lipohypertrophy (LH) detection with a high detection rate, and to construct a classification table for LH, so as to provide reference for LH screening and management.

Methods: From December 2021 to November 2022, 395 hospitalized patients with diabetes from a Tianjin tertiary hospital were enrolled. The LH was detected through ultrasound scanning (USS), structured visual palpation (SVP), and ordinary visual palpation (OVP), and the detection rates were compared. A classification table for LH (LH-LNT table) was constructed based on SVP characteristics.

Results: Under USS, SVP, and OVP, the detection of LH was 89.6%, 78.0%, and 66.6% respectively, with site detection at 92.3%, 71.2%, and 57.8% respectively, showcasing statistically significant differences among the three methods. SVP had a lower misdiagnosis rate than OVP, with upper arm and thighs being common misdiagnosed sites. LH was mostly found in the lower abdomen, flat, and soft on palpation. L1N2T1 (two soft LH on abdomen) was the main type, accounting for 35.4%.

Conclusions: SVP is useful for detecting LH and deserves clinical promotion. The LH-LNT table constructed here effectively summarizes patient LH status, aiding doctor-nurse-patient communication.