Perciun Rodica
National Institute of Diabetes, Nutrition and Metabolic Diseases Prof. N. Paulescu, 20 Precupetii Vechi str., sector 2, 020685 Bucharest, Romania.
Med Ultrason. 2010 Jun;12(2):104-9.
The aim of the study was to evaluate by ultrasonography the local dystrophies caused by insulin subcutaneous injections. The insulin treated diabetic patients must inject their long life insulin into normal tissue. The objective was to add ultrasonographic arguments to the clinic examination in order to periodically reconsider the available area to be used.
Forty insulin treated patients (14 male, 26 female) were clinically diagnosed with hypertrophic, atrophic, nodular, or inflammatory-like tissue dystrophies as a consequence of injections. These local dystrophies are not always conspicuous, barely suggesting a subdermal pathology. US evaluation, mainly subcutis, was used for assessing them.
Besides the clinical signs, ultrasonography offers some distinct appearances: a simple subcutis hypertrophy, a variety of nodular-shaped or diffuse hyperechogenity, subcutis atrophy, complex multilayer changes or possible inflammatory reactions. These abnormal entities have led to erratic insulin absorption and glucose control deterioration, if the patients have continued to inject into the same areas.
Ultrasound interrogation should be used as a non-invasive measure for diagnosing insulin injections local dystrophies. Once diagnosed, their future evolution should be observed. By making a real ultrasonographic map of the injected areas a functional insulin treatment could be obtained and preserved.
本研究旨在通过超声检查评估胰岛素皮下注射引起的局部营养障碍。接受胰岛素治疗的糖尿病患者必须将长效胰岛素注射到正常组织中。目的是为临床检查增加超声论据，以便定期重新考虑可用的注射区域。
40例接受胰岛素治疗的患者（14例男性，26例女性）临床上被诊断为因注射导致的肥厚性、萎缩性、结节性或炎症样组织营养障碍。这些局部营养障碍并不总是明显的，几乎没有提示皮下病变。主要对皮下组织进行超声评估以评估这些病变。
除临床体征外，超声检查还呈现出一些不同的表现：单纯皮下组织肥厚、多种结节状或弥漫性高回声、皮下组织萎缩、复杂的多层变化或可能的炎症反应。如果患者继续在同一区域注射，这些异常情况会导致胰岛素吸收不稳定和血糖控制恶化。
超声检查应作为诊断胰岛素注射局部营养障碍的一种非侵入性方法。一旦确诊，应观察其未来的发展。通过绘制注射区域的真实超声图像，可以实现并维持有效的胰岛素治疗。
