Director and Consultant Physician at Jaipur Diabetes Research Centre, Jaipur, Rajasthan.
Founder, Consultant Diabetologist, Vijayratna Diabetes Diagnostic Treatment Centre, Ahmedabad, India.
Diabetes Technol Ther. 2020 Oct;22(10):777-786. doi: 10.1089/dia.2019.0494. Epub 2020 Sep 16.
Although insulin delivery devices are widely used by the patients, there is a paucity of published guidelines to help professionals manage their patients in insulin therapies. To provide simple and easily implementable guidelines to health care physicians on the choice of insulin delivery devices in routine clinical practice, experts in diabetes gathered together and discussed the recommendations at the National insulin Summit 2018. An ideal insulin delivery device should accurately deliver the prescribed dose of insulin and be easy to use. Recommendations are: (1) insulin should be initiated by using an insulin device if the patient seems to discontinue insulin therapy. (2) Pen devices offer accurate dosing than a syringe and vial and are associated with cost savings in the long term. (3) Switching over from syringes and vial to disposable pen devices improves adherence. (4) FlexPen offers better accuracy, and it requires lower dose force and injection force than SoloStar and KwikPen (5). Durable delivery pens such as NovoPen 4 maintain accuracy and low dose force compared with vials and syringes. (6) One pen should be used by only one patient. (7) Regular counseling on the proper use of the pen device is required regularly. This consensus-based recommendation is a useful reference tool for health care practitioners to initiate insulin therapy in patients with diabetes by using the appropriate insulin pen device.
尽管胰岛素输送装置在患者中广泛使用,但缺乏已发表的指南来帮助专业人员在胰岛素治疗中管理患者。为了在常规临床实践中为医疗保健医生提供关于选择胰岛素输送装置的简单易行的指南,糖尿病专家聚集在一起,在 2018 年国家胰岛素峰会上讨论了这些建议。理想的胰岛素输送装置应能准确输送规定剂量的胰岛素,且易于使用。建议如下:(1)如果患者似乎停止胰岛素治疗,应使用胰岛素输送装置开始胰岛素治疗。(2)笔式装置比注射器和小瓶更能准确给药,并可长期节省成本。(3)从注射器和小瓶切换到一次性笔式装置可提高用药依从性。(4)FlexPen 比 SoloStar 和 KwikPen(5)具有更高的准确性,且所需的剂量用力和注射用力更低。(5)与小瓶和注射器相比,耐用的输送笔如 NovoPen 4 可保持准确性和低剂量用力。(6)一支笔应由一名患者专用。(7)应定期对笔式装置的正确使用进行常规咨询。本基于共识的推荐意见为医疗保健从业者提供了有用的参考工具,以通过适当的胰岛素笔式装置为糖尿病患者启动胰岛素治疗。