CAJ | 학술논문

目的观察糖尿病患者应用无针注射器INJEX30和胰岛素笔对胰岛素吸收和血糖控制的影响.方法 30例病情稳定接受胰岛素治疗的糖尿病患者应用无针注射器INJEX30和胰岛素笔进行随机交叉自身前后对照,试验期间两种不同注射方式之间间隔3d,空腹及标准餐后20、40、60 min采血标本测定血浆葡萄糖、血清总胰岛素和C肽.结果标准餐刺激后血糖、C肽的曲线下面积(AUC) INJEX30组小于胰岛素笔注射组[血糖AUC:(542±172) min·mmol·L-1比(601±199) min·mmol·L-1.P＜0.01;C肽AUC:(70±53) min· μg· L-1比(80±58) min·μg·L-1,P＜0.01].血清总胰岛素AUC INJEX30组大于胰岛素笔注射组[(5621±3790) min·mIU·L-1比(4285±3376) min·mIU·L-1,P＜0.01].体重指数(BMI)＜ 25.24 kg/m2时,两种胰岛素注射方式的总胰岛素AUC差异无统计学意义,BMI≥25.24 kg/m2时,总胰岛素AUC INJEX30组高于胰岛素笔注射器组[(6453±4099) min·mIU·L-1比(4879±3701) min·mIU·L-1,P＜0.01].结论无针注射器INJEX30注射胰岛素较胰岛素笔注射者血清总胰岛素浓度高、血糖较低；且在BMI较高的糖尿病患者中,无针注射器注射后较胰岛素笔注射血清总胰岛素浓度高.
목적 관찰당뇨병환자응용무침주사기INJEX30화이도소필대이도소흡수화혈당공제적영향.방법 30례병정은정접수이도소치료적당뇨병환자응용무침주사기INJEX30화이도소필진행수궤교차자신전후대조,시험기간량충불동주사방식지간간격3d,공복급표준찬후20、40、60 min채혈표본측정혈장포도당、혈청총이도소화C태.결과 표준찬자격후혈당、C태적곡선하면적(AUC) INJEX30조소우이도소필주사조[혈당AUC:(542±172) min·mmol·L-1비(601±199) min·mmol·L-1.P＜0.01;C태AUC:(70±53) min· μg· L-1비(80±58) min·μg·L-1,P＜0.01].혈청총이도소AUC INJEX30조대우이도소필주사조[(5621±3790) min·mIU·L-1비(4285±3376) min·mIU·L-1,P＜0.01].체중지수(BMI)＜ 25.24 kg/m2시,량충이도소주사방식적총이도소AUC차이무통계학의의,BMI≥25.24 kg/m2시,총이도소AUC INJEX30조고우이도소필주사기조[(6453±4099) min·mIU·L-1비(4879±3701) min·mIU·L-1,P＜0.01].결론 무침주사기INJEX30주사이도소교이도소필주사자혈청총이도소농도고、혈당교저；차재BMI교고적당뇨병환자중,무침주사기주사후교이도소필주사혈청총이도소농도고.
Objective To evaluate the effect of the needle free injection system (INJEX30) and insulin pen on insulin absorption and glycemic control in diabetic patients.Methods A total of 30 diabetic patients on insulin therapy without obvious complications were enrolled in the study with average BMI of 25.24 kg/m2.A comparison study was carried out in those subjects with the INJEX30 and insulin pen at 1 st day and 5th day.After an overnight fasting of 8-10 h,a standard mixed meal(50 g bread,50 g egg and 250 ml milk) was given to each patient.Blood samples at 0,20,40,60 min of the standard mixed meal were collected to test plasma glucose,serum insulin and C peptide.Results No difference was shown in fasting plasma glucose,serum insulin and C peptide between the patients with the two injection methods.The area under the curve (AUC) of plasma glucose and serum C peptide was significantly lower after the INJEX30 injection than that after insulin pen injection [plasma glucose AUC (542 ± 172) min · mmol · L-1 vs (601 ±199) min· mmol · L-1,P ＜0.01; C peptide AUC (70 ±53) min · μg · L-1 vs (80 ±58) min · μg · L-1,P ＜0.01].The AUC of serum insulin was significantly higher after the INJEX30 injection than that after insulin pen injection [serum insulin AUC(5621 ± 3790) min · mIU · L-1 vs(4285 ± 3376) min · mIU · L-1,P ＜0.01].No difference was found in the AUC of serum insulin between the two injection methods in the patients with BMI below 25.24 kg/m2,while the AUC of serum insulin was significantly higher after the INJEX30 injection than the insulin pen injection in the patients with BMI above 25.24 kg/m2 [serum insulin AUC(6453 ± 4099) min · mIU · L-1 vs (4879 ± 3701) min · mIU · L-1,P ＜0.01].Conclusion The INJEX30 improves the serum insulin level which may lead to a beneficial effect on the glycemic control.Such effect is more obvious in the overweight patients.