Pens versus syringes to deliver insulin among elderly patients with type 2 diabetes: a randomized controlled clinical trial

Diabetology & Metabolic Syndrome

Gabriela Pereira de Moura¹  Betina Vescovi¹  Rafaela Ramos Nunes²  Raquel Ferreira²  Henrique Umpierre Pedroso²  Thayme Luisa Souza Pires²  Gustavo Fonseca Cipriani³  Rafael Vaz Machry⁴  Ticiana Costa Rodrigues⁵ 

[1] Medical School, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil;Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil;Post Graduate Program in Medical Sciences–Endocrinology, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, Brazil;Post Graduate Program in Medical Sciences–Endocrinology, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, Brazil;Department of Internal Medicine, Medical School, Universidade Federal de Santa Maria, Avenida Roraima 1000, Santa Maria, RS, Brazil;Medical School, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil;Post Graduate Program in Medical Sciences–Endocrinology, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, Brazil;Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil;Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil;

关键词: Type 2 Diabetes;    Elderly;    Pen devices;    Insulin;    Adherence;    Glycemic control;   

DOI  :  10.1186/s13098-021-00675-y

来源: Springer

【 摘 要 】

BackgroundDiabetes mellitus (DM) is a prevalent disease among elderly population. As the disease progresses, insulin may become necessary. The use of pens application seems to be more practical. However, the influence of this method on glycemic control needs to be defined in elderly people.MethodsRandomized clinical trial comparing pens and syringes for insulin application among patients with type 2 DM over 60 years old and Glycated Hemoglobin > 8.5% at baseline. The follow-up was 24 weeks, with monthly medical visits to adjust the treatment. All patients received insulin NPH and, if necessary, insulin Regular. We assessed glycemic control, adherence to treatment, hypoglycemia occurrence, need for adjustment in treatment and impact on quality of life,ResultsWe included 121 patients with mean age of 65.75 years. Sixty-one were randomized for pen group (PG) and 60 patients for syringe group (SG). At baseline, mean HbA1c was 10.34 ± 1.66% and 9.90 ± 1.25% (p = 0.103) in PG and SG respectively. Mean HbA1c was 8.39 ± 1.28% in PG and 8.85 ± 1.74% in SG (p = 0.101) at 24 weeks. However, there was a more significant reduction in PG (− 1.94 ± 1.93% in PG and − 1.04 ± 1.46% in SG, p < 0.05) during follow-up. We found no difference in treatment adherence rates, hypoglycemia, greater need for insulin doses or oral medication, and progression to basal-bolus insulin scheme. We also found no difference in the impact of the disease on quality of life between groups.ConclusionAlthough we did not find any difference in the impact on quality of life, frequency of hypoglycemia or adherence, the PG showed a reduction in HbA1c higher in 24 weeks of follow-up.Clinical trial registration: NCT02517242

【 授权许可】

CC BY