{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T01:47:40Z","timestamp":1783129660447,"version":"3.54.6"},"reference-count":32,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T00:00:00Z","timestamp":1743552000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To investigate the effects of different subtypes of lipohypertrophy (LH) on insulin total daily dose (TDD) requirements in patients with type 1 diabetes mellitus (T1DM), and to propose subtype\u2010specific insulin dosage adjustment strategies after avoiding injection at sites of LH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective observational study enrolled hospitalised T1DM patients with a disease duration \u22651\u2009year. Point\u2010of\u2010care ultrasound was performed immediately after their admission to determine the presence and the specific type of LH. An insulin pump was installed away from the LH sites of each patient. Continuous subcutaneous insulin was infused to control their blood glucose, and the insulin dose was titrated gradually until their blood glucose stabilised to the target.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 288 patients were included. According to ultrasound screening, 104 patients (36.11%) were LH free (LH\u20100) and 184 patients (63.89%) were found to have LH (LH+), of which 114 had nodular hyperechoic LH (LH\u20101), 62 had diffuse hyperechoic LH (LH\u20102) and 8 had hypoechoic LH (LH\u20103). Paired\u2010sample t\u2010test showed that all LH+ groups had a decrease in TDD and TDD\/body weight after avoiding injections at the lesion sites (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Compared with the LH\u20100 group, the TDD and TDD\/body weight of the LH\u20102 and LH\u20103 groups were significantly reduced (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), whereas there was no significant change in the LH\u20101 group. Among the TDD reduced in the LH\u20102 and LH\u20103 groups, the bolus insulin dosage reduced accounted for the vast majority, with 88.05% (8.55\/9.71 international unit [IU]\/day) and 74.78% (18.12\/24.23\u2009IU\/day), respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TDD reductions vary among patients with different subtypes of LH. Nodular hyperechoic LH may not require immediate dose adjustments. Patients with diffuse hyperechoic and hypoechoic LH necessitate bolus\u2010focused dose reductions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dme.70034","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T12:13:55Z","timestamp":1743768835000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Impact of ultrasound\u2010diagnosed lipohypertrophy subtypes on insulin regimen adjustments in patients with\n                    <scp>T1DM<\/scp>"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1746-8123","authenticated-orcid":false,"given":"Jian","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Endocrinology The First Affiliated Hospital with Nanjing Medical University (Jiangsu Province Hospital)  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology The First Affiliated Hospital with Nanjing Medical University (Jiangsu Province Hospital)  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meijing","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Endocrinology The First Affiliated Hospital with Nanjing Medical University (Jiangsu Province Hospital)  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology The First Affiliated Hospital with Nanjing Medical University (Jiangsu Province Hospital)  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Hang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound The First Affiliated Hospital with Nanjing Medical University (Jiangsu Province Hospital)  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology The First Affiliated Hospital with Nanjing Medical University (Jiangsu Province Hospital)  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology The First Affiliated Hospital with Nanjing Medical University (Jiangsu Province Hospital)  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingjing","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Nursing The First Affiliated Hospital with Nanjing Medical University (Jiangsu Province Hospital)  Nanjing China"},{"name":"School of Public Health Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,2]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dci21-0043"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn115791-20220916-00474"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-019-0650-2"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/19322968231187661"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.7.5.479"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.28.8.2025"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-016-0187-6"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabet.2013.05.006"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2016.0334"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.26442\/00403660.2019.04.000128"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2020.107806"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000001742"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13764"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-017-0675-1"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-021-02904-w"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics13091515"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn115791-20201209-00706"},{"issue":"1","key":"e_1_2_8_20_1","first-page":"1","article-title":"Expert 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