Insulin delivery by pen linked to better control of blood sugar than syringe: Study

Diabetes mellitus, more commonly referred to as diabetes, is a metabolic disease that raises blood sugar levels. A hormone produced in the pancreas called insulin moves sugar from the blood into your cells to be stored or used for energy. With diabetes, the body either doesn't make enough insulin or can't effectively use its insulin. Hence as the disease advances, receiving external insulin is required. However there are barriers associated with treatment with insulin that may impair blood sugar control. Fear of hypoglycemia or sudden fall of blood sugar, interference in daily activities, greater number of applications per day and economic issues can cause difficulty in getting adequate management of disease.

This insulin can be delivered via pens and syringes. However, the use of pens application seems to be more feasible; but its influence on controlling blood sugar levels in elderly people has not been clearly defined yet.

A study was conducted by a group of researchers from Brazil to investigate the influence of delivery of insulin through pen on blood sugar levels.

The researchers conducted a clinical trial for comparing pens and syringes for insulin application among patients with type 2 diabetes mellitus over 60 years old and glycated hemoglobin greater than 8.5% at baseline.

They selected a total of 121 patients with a mean age of 65.75 years. Out of which 61 were randomized for pen group (PG) and 60 patients for the syringe group (SG). Their follow-up was at 24 weeks, with monthly medical visits to adjust the treatment. All patients received either received just insulin NPH and, if required, insulin Regular.

They evaluated the glycemic control, treatment adherence, hypoglycemia occurrence, need for adjustment in treatment, and impact on quality of life.

The results of the study are as follows:

· At baseline, mean HbA1c was 10.34 ± 1.66% in the pen group and 9.90 ± 1.25% in the syringe group.

· Mean HbA1c was 8.39 ± 1.28% in in the pen group and 8.85 ± 1.74% in in the syringe group at 24 weeks.

· However, there was a more reduction in pen group during follow-up.

· While they found no difference in treatment adherence rates, hypoglycemia, greater need for insulin doses or oral medication, and progression to basal-bolus insulin scheme.

· They also found no difference in the impact of the disease on the quality of life between groups.

The researchers concluded that though they did not find any difference in the impact on quality of life, frequency of hypoglycemia, or adherence, the pen the group showed a reduction in HbA1c higher in 24 weeks of follow-up.

Reference:

A study titled, "Pens versus syringes to deliver insulin among elderly patients with type 2 diabetes: a randomized controlled clinical trial" by Machry R et. al published in the Diabetes and Metabolic Syndrome journal.

https://dmsjournal.biomedcentral.com/articles/10.1186/s13098-021-00675-y