胰岛素轮换注射卡在2型糖尿病患者胰岛素注射安全中的作用

Role of the rotating insulin weekly abdominal injection card in safe injection of insulin in patients with type 2 diabetes mellitus

目的：探讨如何利用腹部星期定位胰岛素轮换注射卡改善糖尿病患者胰岛素笔的注射安全性。方法2013年1—9月在广西科技大学第一附属医院内分泌科住院的2型糖尿病患者，2013年1—4月入院者为对照组，62例，2013年6—9月入院者为胰岛素轮换注射卡组（简称注射卡组），66例，注射卡组在对照组基础上使用腹部星期定位胰岛素轮换注射卡。入院2周时比较两组患者的胰岛素注射安全规范缺失情况，3个月时间终点时对血糖达标率、不良事件发生率进行比较。结果注射卡组胰岛素注射安全规范缺失情况优于对照组，对比轮换注射部位两组得分分别为0.59±0.14和2.67±0.21（P〈0.01），胰岛素轮换注射卡组患者空腹血糖达标率（84.9%）优于对照组（61.3%）、糖化血红蛋白达标率（78.8%）优于对照组（56.5%）（均P〈0.01），而注射局部不良事件发生率（1.5%）低于对照组（12.9%），差异有统计学意义（P〈0.05）。结论应用腹部星期定位胰岛素轮换注射卡，在提高胰岛素注射规范轮换部位依从性、降低患者胰岛素注射安全规范缺失情况、提高血糖达标率、降低局部不良事件发生率上取得了很好的效果。

Objective To investigate how to improve safety of insulin injection in type 2 diabetes patients by“insulin pen”through the rotating insulin weekly abdominal injection card. Method All the inpatients with type 2 diabetes in the Department of 3rd Internal Medicine from January to September, 2013 were enrolled in this study. Insulin Injection Card group was composed of 66 type 2 diabetes patients who were admitted from June to September, while control group was composed of 62 type 2 diabetes patients admitted from January to April. The difference between Insulin Injection Card group and control group was that the former group used the rotating insulin abdominal injection card weekly which was designed by ourselves, while the control group patients did not use the card. Every participant of both groups was evaluated at 2 weeks of treatment by percentage of patients having absence of Safety standard of insulin injection, and at the end of 3 months of treatment by percentage of patients attaining the therapeutic targets and incidence of adverse events. Result Compared with the control group, patients in Insulin Injection Card group had lower proportion of absence of Safety standard for insulin injection. The scores of rotation injection site in the two groups was 0.59±0.14 and 2.67±0.21（P〈0.01）. The rate of FPG target achievement of patients in Insulin Injection Card group （84.9%） was higher than that of the control group （61.3%）（P〈0.01）, the rate of HbA1c target achievement of patients in Insulin Injection Card group （78.8%） was higher than that of the control group （56.5%）（P〈0.01）. Patients in Insulin Injection Card group had lower incidence of local adverse events （1.5%） compared with the control group （12.9%）（P〈0.05）. Conclusion Use of the rotating insulin weekly abdominal injection card that was designed by the diabetes health management Quality Control Group in our department showed good effect in achieving therapeutic targets （including HBA1C） and decreasing safety standard deficiency of insulin injection and adverse events.