Diagnostic triage for ultrasound-detected subclinical insulin

A single-center diagnostic prediction-model study from Beijing Hospital reports that ultrasound can detect subclinical insulin injection-related lipohypertrophy even when injection sites look normal. Researchers screened adults aged 60 or older with diabetes who had been using subcutaneous insulin between January 2025 and January 2026. From 1,000 screened, 182 were excluded after visual inspection or palpation already found abnormalities; 818 underwent standardized examinations followed by high-frequency ultrasound. Ultrasound found subclinical lipohypertrophy in 15.8% (95% CI, 13.4%–18.4%). Using internally validated ridge logistic models, investigators estimated that at certain operating points, hundreds of ultrasound exams could be avoided per 1,000 patients while missing a small number of lesions.