Outcomes Following Infusion of Insulin Into Ultrasound-Detected Hyperechogenic Tissue in Youth Using Automated Insulin Delivery: A Paired Post Hoc Analysis

Background: Ultrasound frequently detects hyperechogenic tissue at recent insulin infusion sites in youth using automated insulin delivery, but its short-term clinical significance is unclear. Methods: In this post hoc paired analysis of a prior 4-week prospective study, participants were included if they had both hyperechogenic and normoechogenic findings at the most recently used infusion site across 3 visits. Insulin dose and continuous glucose monitoring metrics from days 1 to 2 after infusion-set placement were compared within participants. Results: Seventeen participants met the inclusion criteria. Insulin dose and continuous glucose monitoring–derived outcomes did not differ significantly between tissue categories. Time since infusion-set removal differed between categories (1.6 vs 2.1 days, P = .049). Conclusions: In this paired analysis, binary ultrasound classification alone did not explain short-term glycemic variation.