Ultrasound Detected Subcutaneous Changes in a Pediatric Cohort After Initiation of a New Insulin Pump or Glucose Sensor
Authors' conclusion
There is large variation in the distance from the skin surface to the muscle fascia and many diabetes devices reach even deeper. Hyperechogenicity and vascularization increased significantly over time at CSII sites, but not CGM sites.
Study context
- Population
- Children and adolescents during the first year after initiation of a new diabetes device (continuous subcutaneous insulin infusion (CSII) or continuous glucose monitoring (CGM))
- Participants
- 161 children
- Exposure
- CSII vs CGM
- Outcome
- Subcutaneous tissue changes (echogenicity, vascularization, skin-to-muscle distance) at CSII and CGM sites by US, and association with HbA1c
- Follow-up
- First year
Methodological detailsultrasound assessment
- Ultrasound assessment
Main finding
As reported in the abstract
Subcutaneous changes at device sites
- Mean distance for boys, abdomen (all ages)
- 4.5-6.5 mm
- Mean distance for boys, upper arm (all ages)
- 5-6.9 mm
- Hyperechogenicity at CGM sites after 12 months
- 4.3%
- Hyperechogenicity at CSII sites increased over time
- 41.2% to 69.3%; P < 0.001
- Vascularization at CSII sites increased over time
- 2% to 16%; P = 0.009
Observational data: associations, not effects.
Further findings
Hyperechogenicity as predictor of elevated HbA1c
- Hyperechogenicity in the subcutis was not a predictor of elevated HbA1c
- P = 0.11
Original publication
Ultrasound Detected Subcutaneous Changes in a Pediatric Cohort After Initiation of a New Insulin Pump or Glucose Sensor. Diabetes Technol Ther. Published 6 June 2023. doi:10.
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