Krahulec B, Strbová L, Seböková E, Cárský J, Klimes I
III. interná klinika FN a LF UK, Bratislava.
Vnitr Lek. 1996 Sep;42(9):640-5.
The aim of the study was to investigate changes in insulin wastage when transferring patients from vial insulin to Actraphane HM Penfills and NovoPen II. Twenty four diabetic patients, were treated with Actraphane HM 40 IU/ml vial for 3 months, then transferred to Actraphane HM Penfill and NovoPen II for further 3 months. Wastage 1 (difference between insulin consumption and the total prescribed dose) was higher in vials than in Penfills (268.7 +/- 69.4 IU/3 months/patients vs. -7.6 +/- 30.2 IU/3 months/patient, p < 0.001 mean +/- SEM). Wastage 2 (insulin remaining in the container when discharged) was higher in the Penfills than in vials (214.1 +/- 22.04 IU/3 months/patient vs 45.2 +/- 11.2 IU/3 months/patient). Total wastage was 313.9 +/- 67.8 IU/3 months/patient (3.96 IU/day/patient) when using vials and 206.5 +/- 31.2 IU/3 months/patient (2.52 IU/day/patient) when using Penfills (NS). Higher wastage in vials may relate to a larger volume used for "airshot", and to a larger imprecision in the measured and injected dose when using vials. The latter may also be reflected in a significantly higher average incidence of weighted hypogiycemias in the vial period (15 +/- 4.28/3 months/patient) compared to the Penfill period (5.1 +/- 1.2/3 months/patient, p < 0.01). Total wastage was seen to be 29% smaller by using NovoPen II and therefore saving of insulin seems to be possible (approximately 1.44 IU/day/patient).
本研究的目的是调查将患者从瓶装胰岛素转换为阿克他法胰岛素笔芯和诺和笔II时胰岛素浪费情况的变化。24名糖尿病患者先用40 IU/ml的阿克他法胰岛素瓶装制剂治疗3个月，然后转换为阿克他法胰岛素笔芯和诺和笔II再治疗3个月。瓶装胰岛素的浪费量1（胰岛素消耗量与总处方剂量之间的差值）高于笔芯装胰岛素（268.7±69.4 IU/3个月/患者 vs. -7.6±30.2 IU/3个月/患者，p<0.001，均值±标准误）。笔芯装胰岛素的浪费量2（出院时容器中剩余的胰岛素量）高于瓶装胰岛素（214.1±22.04 IU/3个月/患者 vs. 45.2±11.2 IU/3个月/患者）。使用瓶装胰岛素时，总浪费量为313.9±67.8 IU/3个月/患者（3.96 IU/天/患者），使用笔芯装胰岛素时为206.5±31.2 IU/3个月/患者（2.52 IU/天/患者）（无显著差异）。瓶装胰岛素浪费量较高可能与“排气注射”使用的量较大以及使用瓶装胰岛素时测量和注射剂量的较大不精确性有关。后者也可能反映在瓶装胰岛素使用期间加权低血糖症的平均发生率显著高于笔芯装胰岛素使用期间（15±4.28/3个月/患者 vs. 5.1±1.2/3个月/患者，p<0.01）。使用诺和笔II时总浪费量减少了29%，因此似乎有可能节省胰岛素（约1.44 IU/天/患者）。
