Postgraduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Diabetes Care. 2024 Dec 1;47(12):2146-2154. doi: 10.2337/dc24-0157.
To evaluate the clinical and laboratory outcomes of patients with type 2 diabetes by comparing the no reuse or reuse of syringes and needles for insulin injection.
Adults with type 2 diabetes who had reused syringes and needles at least three times were randomly instructed either to not reuse or to reuse insulin syringes and needles five times. The primary outcomes assessed were glycemic control, pain scores, and skin complications (ecchymosis, lipohypertrophy, nodules, infection) at baseline and 4, 8, and 12 weeks after the intervention. Secondary outcomes included treatment adherence, quality of life, microbiological contamination of syringes and needles, needle quality, and insulin injection technique.
Among the 71 participants (mean ± SD age 59.7 ± 8.8 years), 59% were women with a median duration of diabetes of 18 years (interquartile range 10-25 years) and a mean BMI of 31.7 ± 6.7 kg/m2. The group that reused syringes and needles experienced an increase in lipohypertrophy/nodules (0.16 ± 0.08, P = 0.040) but did not experience worsening pain or glycemic control, even when the syringes and needles were inserted into the skin with great effort. There was no difference in the total number of skin complications, quality of life, or microbiological contamination. Both groups improved treatment adherence, with a greater increase in the reuse group.
The reuse of syringes and needles is associated with a modest increase in lipohypertrophy/nodules but does not have a short-term impact on glycemic control in patients with type 2 diabetes.
通过比较 2 型糖尿病患者重复使用和不重复使用胰岛素注射器和针头的情况,评估患者的临床和实验室结果。
至少重复使用 3 次注射器和针头的 2 型糖尿病成人患者被随机分为两组,一组不再重复使用胰岛素注射器和针头,另一组继续重复使用胰岛素注射器和针头 5 次。主要结局评估指标为干预前和干预后 4、8、12 周时的血糖控制、疼痛评分和皮肤并发症(瘀斑、脂肪增生、结节、感染)。次要结局包括治疗依从性、生活质量、注射器和针头的微生物污染、针头质量和胰岛素注射技术。
在 71 名参与者中(平均年龄±标准差为 59.7±8.8 岁),59%为女性,糖尿病病程中位数为 18 年(四分位距为 10-25 年),平均 BMI 为 31.7±6.7kg/m2。重复使用注射器和针头的组脂肪增生/结节增加(0.16±0.08,P=0.040),但疼痛或血糖控制没有恶化,即使注射器和针头以很大的力量插入皮肤。皮肤并发症的总数、生活质量或微生物污染没有差异。两组的治疗依从性都有所提高,重复使用组的提高更为明显。
重复使用注射器和针头会导致脂肪增生/结节适度增加,但在短期内对 2 型糖尿病患者的血糖控制没有影响。