ArticleJournal of the ASEAN Federation of Endocrine Societies2026
Ultrasound-Guided Skin and Subcutaneous Fat Thickness Profiling for Insulin Delivery in Overweight and Obese Adults With Type 2 Diabetes: A Cross-Sectional Malaysian Study.
Article in Journal of the ASEAN Federation of Endocrine Societies, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Safe insulin administration requires delivery into the subcutaneous tissue to avoid intradermal or intramuscular injection. Although international guidelines recommend the universal use of 4 mm needles, local anatomical data supporting this recommendation among overweight and obese adults with type 2 diabetes mellitus (T2DM) in Malaysia are limited. Objective: To assess skin thickness (ST) and subcutaneous adipose tissue (SAT) using ultrasound to evaluate the safety of 4 mm insulin needles in overweight and obese adults. Methodology: This cross-sectional study involved 98 adults with T2DM on insulin therapy (body mass index [BMI] ≥23 kg/m Results: The median abdominal ST was 2.46 mm (interquartile range [IQR]: 2.20-2.80), and upper arm ST was 1.92 mm (IQR: 1.73-2.11). Only 6.1% of participants had any site with ST greater than 4 mm. Median abdominal SAT was 16.75 mm (IQR: 14.83-19.28), and upper arm SAT was 15.38 mm (IQR: 12.10-17.73). Multiple linear regression showed that abdominal ST was significantly predicted by BMI (β = 0.244, Conclusion: Most overweight and obese Malaysian adults with T2DM have adequate ST and SAT for safe insulin delivery using 4 mm pen needles. Ultrasonographic data support individualized injection technique education in primary care, considering BMI, gender, and age.
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