Effect of needle-free jet injection of insulin glargine on glycaemic fluctuation in type 2 diabetic patients with uncontrolled glycemia / 中华内分泌代谢杂志

Objective:To investigate the effects of insulin glargine administration by jet injection versus conventional insulin pen on glucose profile using professional mode flash glucose monitoring(FGM) system in type 2 diabetic patients with poor glucose control.Methods:In this randomized, controlled, crossover study, 40 patients with T2DM who treated with insulin glargine were enrolled. The patients were randomly divided into group A(jet injector-conventional pen, n=20) and group B(conventional pen-jet injector, n=20). Each patient wore FreeStyle Libre sensor from day 4 to day 17. The specialist nurse instructed patients how to master the injection techniques. Professional FGM system was applied to assess glucose profile. Results:The fasting blood glucose(FBG) of the enrolled patients was(9.37±1.84) mmol/L. In contrast to conventional insulin pen, treatment with the jet injector significantly decreased the 24h MBG [(9.06±2.13 vs 9.98±2.67) mmol/L, P=0.001], MaxBG [(16.69±3.01 vs 17.95±3.48) mmol/L, P=0.001], AUC>10 mmol/L [95.93(21.12, 129.02) vs 142.66( 27.88, 198.46), P=0.002], TAR(31.10±21.89 vs 39.49±25.93, P=0.003), MAGE and SDBG. It was observed that patients using jet injector had significant increased TIR(65.94±20.47 vs 58.32±25.00, P=0.001). There were no difference in the risk of hypoglycaemia between two groups. Conclusion:Insulin jet injector was more effective than the insulin pen on glycaemic control and glucose fluctuation without increasing the risk of hypoglycemia in type 2 diabetic patients with uncontrolled glycemia.

Consideration of Application of Insulin Pen Needles and Supervision / 中国医疗器械杂志

With the increasing incidence of diabetes mellitus in China, hypodermic injection of artificial insulin to control blood sugar has been popularized. Insulin pen needles are widely used in hospitals, communities and families. This article attempts to explore and think about the harm and countermeasures brought about by the reuse of insulin pen needles from the perspective of medical device supervision.

Finite element analysis and experimental study of the performance of insulin pen needles / 国际生物医学工程杂志

Objective To compare and analyze the relationship between geometric parameters of the needle of different insulin pens and their puncture force, flow rate, and pressing force. Methods The human skin tissue model and needle model were established, and the finite element simulation analysis of needle puncture was performed. Using a test platform, 25 kinds of needles with different geometric parameters were tested for the puncture force, pushing pressure, flow rate and other parameters. The influence of geometric parameters on the performance of the needles were analyzed. Results The puncture force of the needle was closely related to its section design. Compared with the three-section needle, the five-section needle increases the secondary inclination angle and the condyle angle, increases the contact area between the needle and the tissue, and make the change of the contact angle more smoothly, which reduce the needle penetration force. The smaller the outer diameter of the needle, the smaller the penetrating power. The larger the inner diameter of the needle, the greater the fluid flow rate, the smaller the pushing pressure, and the higher the injection accuracy. Conclusions Five-section, ultra-thin-walled or ultra-thin-walled needles have more excellent performance. On the basis of ensuring the strength of the needle, the needle's geometry can be optimized to reduce the puncture force. The results of this study can provide theoretical basis and experimental basis for the design of needles for insulin pens.

Is the Indicator Magnifying Window for Insulin Pens Helpful for Elderly Diabetic Patients?

Patients with type 2 diabetes who require insulin therapy are commonly elderly and have poor visual acuity. In this study, we examined the clinical usefulness of the indicator magnifying window (IMW) for elderly patients with type 2 diabetes. We recruited 50 patients with type 2 diabetes over the age of 60 who had used insulin pens for glucose control. They were asked to set the insulin pen at randomly selected doses with or without an IMW. We assessed dosing accuracy, convenience, self-confidence, need for eyeglasses, preference, and willingness to recommend the IMW to other patients. Although the IMW did not improve the dosing accuracy or convenience, it significantly decreased the need for eyeglasses. Overall, the clinical usefulness of the IMW is quite limited in elderly patients with type 2 diabetes.

Satisfaction and usability of SoloStar(R) in diabetic patients from China——SUPERSTAR Study / 中华内分泌代谢杂志

Objective To evaluate the satisfaction and usability of SoloStar(R),a prefilled pen for injecting insulin glargine ( Lantus(R),Sanofi ) in Chinese diabetic patients.Methods This was a 3-month,observational,multicenter,prospective registry study in adult diabetic patients who were ever insulin users or insulin naive.The SoloStar(R) was prescribed at physician's discretion.At baseline,patients were asked to evaluate their previous insulin pen if applicable.After 3-month SoloStar(R) use,the satisfaction and usability in using SoloStar(R) were assessed,and the evaluation from physicians was also collected.Results Total 1052 patients aged 56.5 years (27.6％ ≥65years),with mean diabetes duration 7.6 years,54.6％ male,94.1％ type 2 diabetes,6.5％ visual impairment,and 2.4％ dexterity impairment,were analyzed.Of these,488 patients (46.4％) had previously used insulin pen.Most patients (95.3％) rated SoloStar(R) assatisfied/very satisfied.Most patients planned to continue using SoloStar(R)(94.7％) and would recommend it to others(86.0％ ).Compared with previous insulin pen,most patients felt using SoloStar(R) became easier ( 57.3％ ) and more convenient ( 60.7％ ).63 physician questionnaires were analyzed,over 70％ physicians rated SoloStar(R) features as good/excellent,and 96.8％ physicians regarded training on SoloStar(R) as easier and quicker than other pens.Conculsion Most patients were satisfied/very satisfied with SoloStar(R) and most physicians rated SoloStar(R) as good/excellent,suggesting that SoloStar(R) was well accepted by patients and physicians in China.

OBSERVATION OF INSULIN INTENSIVE THERAPY BY INSULIN PEN INJECTORS ON IDDM PATIENTS / 中华内分泌代谢杂志

Seven cases of unstable Type 1 diabetic patients were treated with IIT (intensive insulin therapy) -multi-injection insulin regimen. The short-acting insulin (Actrapid HM) administered by insulin-pen injector (NOVO-Pen 1) before meals as meal-related incremental insulin. The long-acting insulin (Ultratard HM) injected at 10 p.m. as basal insulin. After run-in period of 4 weeks then the IIT-period ran for 12 weeks. The results showed that the mean fasting/post-prandial glucose concentration was normalized from 10.6?2.5/16.2?3.9 mmol/L to6.5?0.9/7.0?2.2mmol/L. The mean HbA, fell from 10.2% to 8.2% (normal 6-8%) during the three months period. It can be concluded that the IIT-multi-injecdon insulin regimen improves metabolic control. The NOVO-Pen seems to be better than the traditional syringe as besides its painless injection, it is easy to use and carry; thus makes the multiple injection regimen more attractive.