Feasibility of using a pocket-sized ultrasound imaging device for detecting insulin-derived amyloidosis-like findings in patients with diabetes mellitus: a preliminary study

Objectives: Insulin-derived amyloidosis (IDA) reduces insulin absorption, increasing the risk of poor glycemic control; however, early detection remains challenging. Although ultrasound can identify IDA, the effectiveness of portable pocket-sized devices has not been evaluated. This study was performed to evaluate the detectability of findings suggestive of IDA using a pocket-sized ultrasound device on the abdominal region, the most common site for stable insulin absorption in patients with diabetes mellitus. Methods: This cross-sectional observational study was conducted in the diabetes ward of a university hospital between July and December 2024. The participants were inpatients with diabetes who had been receiving insulin injections for more than 1 month. Findings suggestive of IDA were assessed through visual inspection and palpation, magnetic resonance imaging (MRI), high-performance ultrasonography, and a pocket-sized ultrasound device. The concordance rate between the pocket-sized ultrasound device and other assessment methods was calculated. Results: Of the 20 participants enrolled, 5 met the exclusion criteria; thus, data from 15 participants were included in the final analysis. Findings suggestive of IDA were identified in nine patients (60.0%) by visual inspection and palpation and in eight patients (53.3%) by the pocket-sized ultrasound device, high-performance ultrasound, and MRI. The concordance rate among the pocket-sized ultrasound device, high-performance ultrasound, and MRI was 100%, while the concordance rate between visual inspection with palpation and the pocket-sized ultrasound device was 80%. Conclusions: These findings suggest that a pocket-sized ultrasound device has the potential to detect findings suggestive of IDA and may be suitable for use in clinical practice.