无针注射器和胰岛素笔皮下注射胰岛素控制初诊2型糖尿病患者血糖控制的效果的比较  

Effect of hypodermic injection of insulin with needle-free syringe versus insulin pen on blood glucose control in patients with newly-diagnosed type 2 diabetes mellitus:a comparative study

作　　者：俸东升 李远 邱锦媚 莫维英 黄炎芳 李羡颜 叶绿荣 黄若飞 吴柳欢 刘世双 覃玉梅 左斌 陈天 杨杰华 FENG Dong-sheng;LI Yuan;QIU Jin-mei;MO Wei-ying;HUANG Yan-fang;LI Xian-yan;YE Lyu-rong;HUANG Ruo-fei;WU Liu-huan;LIU Shi-shuang;QIN Yu-mei;ZUO Bin;CHEN Tian;YANG Jie-hua(Department of Endocrinology,the Third Affiliated Hospital of Guilin Medical University&Wuzhou Red Cross Hospital,Wuzhou 543002,China;Department of Clinical Laboratory,the Third Affiliated Hospital of Guilin Medical University&Wuzhou Red Cross Hospital,Wuzhou 543002,China)

机构地区：[1]桂林医学院附属第三医院暨广西梧州市红十字会医院内分泌科,梧州市543002 [2]桂林医学院附属第三医院暨广西梧州市红十字会医院检验科,梧州市543002

出　　处：《广西医学》2020年第20期2634-2638,共5页Guangxi Medical Journal

基　　金：广西梧州市科学研究与技术开发计划(201402012)。

摘　　要：目的比较采用无针注射器和胰岛素笔皮下注射胰岛素短期强化治疗初诊2型糖尿病(T2DM)患者的效果。方法将62例初诊T2DM患者随机分为无针注射器组(A组)和胰岛素笔组(B组),各31例,均治疗7 d。比较两组患者每次皮下注射胰岛素后疼痛视觉模拟量表(VAS)评分、注射部位出现红肿、药物残留等不良反应情况,以及治疗7 d后空腹血糖、果糖胺、空腹胰岛素(FINS)、C肽和糖化血红蛋白水平,OGTT试验各时点血糖、胰岛素、C肽水平。结果每次皮下注射胰岛素后,A组VAS评分、低血糖和残留药物发生率低于B组,但红点发生率高于B组。治疗第7天,A组空腹血糖、果糖胺和C肽水平低于B组,FINS水平高于B组;A组OGTT试验各时点血糖及空腹、服糖后30 min、60 min、90 min的C肽水平均低于B组,FINS、服糖后30 min、60 min、90 min的胰岛素水平均高于B组,而120 min胰岛素水平低于B组,血糖的曲线下面积(AUC)、C肽的AUC小于B组,胰岛素的AUC大于B组(均P<0.05)。结论与采用胰岛素笔相比,初诊T2DM患者采用INJEX30无针注射器皮下注射胰岛素可以减轻注射痛感,提高血清胰岛素水平,更有效地控制血糖。Objective To compare the efficacy of short-term intensive therapy of subcutaneous insulin injection with needle-free syringe versus insulin pen in patients suffering from newly-diagnosed type 2 diabetes mellitus(T2DM).Methods Sixty-two patients with newly-diagnosed T2DM were randomly divided into needle-free syringe group(group A,31 cases)and insulin pen group(group B,31 cases),and both groups were treated for seven days.The two groups were compared in terms of the Visual Analogue Scale(VAS)score,condition of adverse reactions such as redness and swelling at injection sites and drug residue after each hypodermic injection of insulin,as well as FBG,fructosamine,fasting insulin(FINS),C-peptide and hemoglobin A1c(HbA1c)levels after seven days of treatment,together with blood glucose,insulin and C-peptide levels at all time points in OGTT.Results After each hypodermic injection of insulin,group A had lower VAS score,lower incidence rates of hypoglycemia and drug residue,and increased incidence rate of rash in comparison with group B.On the 7th day of treatment,group A reported lower levels of FBG,fructosamine and C-peptide,and higher FINS level than group B;compared with group B,group A exhibited lower blood glucose levels at all time points in OGTT,lower fasting C-peptide level,lower C-peptide levels 30,60 and 90 minutes after OGTT,increased FINS,and higher insulin levels 30,60 and 90 minutes after OGTT,along with lower insulin level at 120 minutes,decreased area under the curve(AUC)for blood glucose,decreased AUC for C-peptide and greater AUC for insulin(all P<0.05).Conclusion Compared with insulin pen,insulin injection with needle-free syringe(INJEX30)can attenuate injection-induced pain,improve serum insulin level,and achieves more effective blood glucose control in newly-diagnosed T2DM patients.

关 键 词：无针注射器 胰岛素笔 2型糖尿病 血糖 胰岛素 

分 类 号：R587.1[医药卫生—内分泌]