Department of Internal Medicine, Academic Medical Centre, Amsterdam, The Netherlands.
Diabetes Technol Ther. 2010 Jun;12 Suppl 1:S73-7. doi: 10.1089/dia.2009.0178.
Pen injection devices have acquired a pivotal role in insulin delivery, surpassing the use of conventional insulin syringes in many parts of the world. In this review we sought to determine differences in dosing accuracy between insulin pens and conventional syringes and vials, also touching on patient preference. We aggregated relevant literature found by searching the PubMed database, identifying seven relevant articles. There was consensus that pens are more accurate, especially at doses below 5 insulin units (IU). The literature also showed that pens tend to underdose when compared to syringes, but do this with a high degree of consistency. One study assessed influence on glycemic control, and whereas no significant difference was found with respect to hemoglobin A1c, fasting glucose levels decreased significantly more in pen users versus syringe users (-57 +/- 14 vs. 1 +/- 13 mg/dL, P = 0.003). The same study demonstrated that pens improved health-related quality of life compared to syringes and vials. We conclude that, regarding accuracy, there is sufficient evidence to recommend the use of insulin pens when delivering doses below 5 IU. For insulin doses above 5 IU there is no clear benefit for the pen in terms of accuracy.
注射笔在胰岛素给药中扮演着重要的角色，在世界上许多地方，它已经取代了传统的胰岛素注射器。在本综述中，我们旨在确定胰岛素笔与传统注射器和小瓶在给药准确性方面的差异，并探讨患者的偏好。我们通过搜索 PubMed 数据库，汇总了相关文献，共找到了 7 篇相关文章。研究结果表明，笔在剂量低于 5 个单位（IU）时更准确，尤其是在剂量低于 5 个单位（IU）时。文献还表明，与注射器相比，笔往往会出现剂量不足的情况，但这种情况具有高度的一致性。一项研究评估了对血糖控制的影响，尽管血红蛋白 A1c 没有显著差异，但与注射器使用者相比，笔使用者的空腹血糖水平显著降低（-57 +/- 14 与 1 +/- 13 mg/dL，P = 0.003）。同一项研究表明，与注射器和小瓶相比，笔提高了患者的健康相关生活质量。我们得出结论，在剂量低于 5IU 时，使用胰岛素笔具有足够的准确性，因此推荐使用。而在剂量大于 5IU 时，笔在准确性方面并没有明显优势。
