The Efficacy And Safety On Needle-Free Insulin Injection Of Blood Glucose Management In Diabetic Patients

Objective:To observe needle-free injection in insulin therapy for diabetes for the efficacy and safety.Methods:Sixty cases of diabetic patients with substandard blood glucose control who were admitted to the Department of Endocrinology of Handan Central Hospital from January 2020 to December 2020 were selected as the study samples.In this sample,Eleven patients had type 1 diabetes and forty-nine had type 2 diabetes.They had been treated with routine subcutaneous injection of insulin aspart before meals and insulin glargine before sleep for more than three months.All patients based on the initial hypoglycemic program switched to a needle-less device.The flash glucose monitoring(FGM)were used to detect time in target range of glucose(TIR).Changes in the fasting venous plasma glucose(FPG),2 h postprandial venous plasma glucose(2hPG),glycosylated hemoglobin(HbA1c),insulin dosage,postprandial blood glucose fluctuation(PPGE),the largest blood sugar fluctuation(LAGE),the change of blood glucose levels of the standard deviation(SDBG)before and after treatment were compared.To observe the efficacy and safety.Results:The FPG,2hPG,HbA1c,daily insulin dosage,PPGE,LAGE and SDBG were all lower after treatment than before(P<0.05).TIR is an increase(P<0.05).The improvement in HbA1c was more pronouned with type 2 diabetes whose BMI≥24kg/m~2(P<0.05).After the change of needle-free insulin injection,there was no missing injection,no new subcutaneous fat hyperplasia or atrophy and no subcutaneous induration.The VAS score below 4 was 91.67%(55/60),the incidence of hypoglycemic events was 3.33%(2/60),and the incidence of subcutaneous bleeding was5.00%(3/60),but generally disappeared 2 to 7 days after the injection without discomfort.Conclusions:To effectively control blood glucose levels,reduce insulin dosage and improve blood glucose fluctuations,partly to avoid local complications and injection pain and fear with no needle injection ways.Long-term use can improve HbA1c levels and improve the insulin therapy in patients with the compliance.The incidence of hypoglycemia events is low;Needle-free injection combined with FGM may enable patients to achieve better efficacy in blood glucose control and the control target of TIR has been achieved.The type 2 diabetic Patients with high BMI(BMI≥24kg/m~2)may be more suitable for needleless jet insulin injection,and the long-term hypoglycemic efficacy is more obviously improved.