Role of Ultrasound in the Evaluation of Diabetics-Related Complication: A Systematic Review and Meta-Analysis

Diabetes mellitus is associated with a wide spectrum of macrovascular and microvascular complications affecting multiple organ systems. Ultrasound offers a noninvasive, accessible imaging modality for the early detection of these complications. This systematic review and meta-analysis evaluated the diagnostic role of ultrasound across diabetes-related complications, including nephropathy, neuropathy, hepatic fibrosis, carotid atherosclerosis, plantar fasciitis, and cardiac vascular alterations. Relevant studies were identified from PubMed, Scopus, and the Cochrane Library, supplemented by gray literature, and appraised using the Newcastle-Ottawa Scale. The meta-analysis was performed using Jamovi software in accordance with PRISMA guidelines. Pooled findings demonstrated that the renal resistive index (RI) measured by Doppler ultrasound was significantly elevated in diabetic nephropathy compared with controls. Plantar fascia thickness, peripheral nerve cross-sectional area, and liver stiffness were all significantly greater in diabetic patients than in non-diabetic controls (p < 0.05 across outcomes). Carotid intima-media thickness and vascular resistance parameters were also measurably increased, reflecting early atherosclerotic changes. These results confirm that ultrasound is a versatile and diagnostically valid tool across multiple diabetes-related complication domains, with particular strength in hepatic, neurological, renal, and musculoskeletal assessment. The consistent findings across organ systems support its integration into routine diabetic surveillance. Standardized acquisition protocols and larger prospective studies are needed to consolidate reference ranges and strengthen clinical applicability.