Nursing Department, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Front Endocrinol (Lausanne). 2023 Jul 12;14:1162176. doi: 10.3389/fendo.2023.1162176. eCollection 2023.
Needle injection and needle-free injection were proven effective in improving glycated hemoglobin (HbA1c) in type 2 diabetes mellitus (T2DM) patients. However, it is unclear if needle-free and needle injections of insulin during intensive insulin therapy in hospitalized patients provide similar efficacy and safety benefits.
A self-controlled cross-over study was conducted on 62 patients with T2DM who received intensive long-acting and short-acting insulin injections with or without needles. The 7-point blood glucose test was performed on the 6th day after insulin administration and the injection method switched on the 7th day of hospitalization. The difference was compared in 7-point blood glucose levels.
The blood glucose levels at fasting (mean difference=-1.09 ± 2.38mmol/L, 95% CI, -1.69 to -0.48, p=0.0007) and post-breakfast (-1.14 ± 3.02mmol/L, 95%CI, -1.91 to -0.37, p=0.004) were better when patients were receiving needle-free injections compared to when receiving a needle injection. Indeed, daily blood glucose fluctuation, which presented as the area under the curve of glycemia, was decreased in needle-free injection periods (-0.3.48 ± 9.64, 95%CI, -5.95 to -1.01, p=0.0065). There was no significant difference in the dose of long-acting insulin between the two injection methods (-0.32 ± 2.69, 95%CI, -0.99 to 0.37, p>0.05). The dose of fast-acting insulin during the needle-free period was lower than that of when patients received needle injections (-1.66 ± 6.45, 95%CI, -3.29 to -0.025, p<0.05). There was no significant difference in satisfaction between the two regimens (-0.59 ± 1.55,95%CI, -0.938 to 0.509, p=0.557), but there was a significant difference in pain experience, favoring needle-free injections (p < 0.001).
Glycemia was better controlled by needle-free insulin injections in hospitalized T2DM patients subjected to intensive glycemic control. These patients also experienced less pain than when insulin was injected with a needle.
在 2 型糖尿病（T2DM）患者中，针注射和无针注射已被证明可有效改善糖化血红蛋白（HbA1c）。然而，尚不清楚强化胰岛素治疗期间住院患者的无针和针注射胰岛素是否具有相似的疗效和安全性益处。
对 62 例接受长效和短效胰岛素强化注射的 T2DM 患者进行自身对照交叉研究，分别采用有针和无针注射胰岛素。在胰岛素给药后的第 6 天进行 7 点血糖检测，并在住院第 7 天切换注射方法。比较 7 点血糖水平的差异。
与针注射相比，无针注射时空腹（平均差值=-1.09±2.38mmol/L，95%CI，-1.69 至-0.48，p=0.0007）和早餐后（-1.14±3.02mmol/L，95%CI，-1.91 至-0.37，p=0.004）的血糖水平更好。无针注射期间的每日血糖波动（表现为血糖曲线下面积）降低（-0.348±9.64，95%CI，-5.95 至-1.01，p=0.0065）。两种注射方法之间长效胰岛素剂量无显著差异（-0.32±2.69，95%CI，-0.99 至 0.37，p>0.05）。无针期间速效胰岛素剂量低于针注射时（-1.66±6.45，95%CI，-3.29 至-0.025，p<0.05）。两种方案的满意度无显著差异（-0.59±1.55，95%CI，-0.938 至 0.509，p=0.557），但疼痛体验有显著差异，无针注射更优（p<0.001）。
强化血糖控制的住院 T2DM 患者接受无针胰岛素注射可更好地控制血糖。与针注射相比，这些患者的疼痛也更少。
