Peyrot Mark, Dreon Darlene, Zraick Vivien, Cross Brett, Tan Meng H
Department of Sociology, Loyola University Maryland, Baltimore, MD, USA.
Calibra Medical, Wayne, PA, USA.
Diabetes Ther. 2018 Feb;9(1):297-307. doi: 10.1007/s13300-017-0365-1. Epub 2018 Jan 11.
A basal-bolus insulin regimen is needed to achieve glycated hemoglobin A1c (HbA1c) below 7.0% in people with type 1 (T1D) or type 2 (T2D) diabetes who have significant loss of beta-cell function. Nonadherence to therapy is common and negatively affects the ability to reach treatment goals. We examined patient assessment of a new, wearable mealtime insulin-delivery system (patch) relative to their current mealtime insulin-delivery system (syringe, pen, or pump). The patch is designed to deliver only boluses of fast-acting insulin (no basal insulin), mechanically controlled by the patient.
Adults (n = 101) with T1D or T2D assessed their current mealtime insulin-delivery system and then assessed simulated (no active medication) patch use over a 3-day period. Participants evaluated mealtime insulin-delivery systems using eight measures from five domains (convenience, interference with daily activities, diabetes-related worry, psychological well-being, and overall satisfaction/preference) on the self-administered Insulin Delivery System Rating Questionnaire. User ratings of their current insulin-delivery systems (syringe, pen, pump) were compared with those for the patch by repeated measure analysis of variance and one-sample t tests.
Participants had significant (p < 0.05) preference for patch over syringe in all eight comparisons, and over pen in five out of eight comparisons, with no significant preference for pen. Although there was a preference for patch over pump in six out of eight comparisons, only one showed a significant preference for patch, and one for pump. Significantly more participants reported that they would like to switch to the patch than continue using a syringe (78% vs 22%) or pen (76% vs 24%) but this difference was not significant for the group using a pump (52% vs 48%).
Participants preferred using the patch over pens and syringes. Its ease of use and discreet method of insulin delivery may contribute to improved patient adherence to mealtime insulin regimens among people currently using injection devices.
Calibra Medical.
对于1型糖尿病（T1D）或2型糖尿病（T2D）且β细胞功能严重丧失的患者，需要采用基础-餐时胰岛素治疗方案以使糖化血红蛋白A1c（HbA1c）低于7.0%。治疗依从性差很常见，并且会对实现治疗目标的能力产生负面影响。我们研究了患者对一种新型可穿戴餐时胰岛素输送系统（贴片）相对于其当前餐时胰岛素输送系统（注射器、笔或泵）的评估。该贴片设计为仅输送速效胰岛素大剂量（无基础胰岛素），由患者进行机械控制。
101名患有T1D或T2D的成年人评估了他们当前的餐时胰岛素输送系统，然后在3天内评估了模拟（无活性药物）贴片的使用情况。参与者使用自我管理的胰岛素输送系统评分问卷中来自五个领域（便利性、对日常活动的干扰、糖尿病相关担忧、心理健康和总体满意度/偏好）的八项指标对餐时胰岛素输送系统进行了评估。通过重复测量方差分析和单样本t检验，将参与者对其当前胰岛素输送系统（注射器、笔、泵）的评分与对贴片的评分进行比较。
在所有八项比较中，参与者对贴片的偏好均显著高于注射器（p < 0.05），在八项比较中的五项中高于笔，对笔没有显著偏好。虽然在八项比较中的六项中对贴片的偏好高于泵，但只有一项显示对贴片有显著偏好，一项对泵有显著偏好。报告愿意改用贴片的参与者显著多于继续使用注射器（78%对22%）或笔（76%对24%）的参与者，但对于使用泵的组而言，这种差异不显著（52%对48%）。
参与者更喜欢使用贴片而非笔和注射器。其易用性和隐秘的胰岛素输送方式可能有助于提高目前使用注射装置的患者对餐时胰岛素治疗方案的依从性。
Calibra Medical。
