RESUMEN
OBJECTIVE: To evaluate the frequency of non-inert material, including cells, in needles and cartridges after insulin injection with pen-like devices in diabetic patients. RESEARCH DESIGN AND METHODS: A prospective study was conducted in 120 insulin-treated diabetic patients who used pen-like devices. The patients, 46 women and 74 men, were 20-77 years old; 60% had type 1 diabetes, and 38% were overweight. Duration of diabetes ranged from 1 month to 40 years, and insulin therapy ranged from 1 month to 30 years. Insulin injection was performed by a trained nurse, using the patient's usual pen and cartridge. A cytopathological examination was performed on the material obtained from the needle and found in the cartridge after centrifugation. All slides were read by a single investigator. RESULTS: In 62% of the patients, non-inert material was found, including squamous (32%) and epithelial (58%) cells. Biologic material was found in 30% of the needles and 58% of the cartridges, and in both needle and cartridge in 25% of the population. Biologic material was found more frequently in patients who had a longer duration of diabetes, who were treated with insulin for a longer time, and who performed injection in the thighs or upper arms (P < 0.05). In multivariate analysis, the presence of biologic material was associated with the duration of diabetes (R2 = 0.09; P < 0.01). CONCLUSIONS: Our data suggest that biologic material can be trapped in the delivery system, including the cartridge, after an insulin injection with a pen-like device. Our results emphasize the strict need for individual use of insulin delivery systems, including cartridges and nonrefillable pens, especially in clinics and hospitals.
Asunto(s)
Diabetes Mellitus Tipo 1/tratamiento farmacológico , Células Epiteliales , Insulina/administración & dosificación , Agujas , Piel/citología , Jeringas , Adulto , Anciano , Diabetes Mellitus/tratamiento farmacológico , Contaminación de Equipos , Femenino , Humanos , Inyecciones Subcutáneas/instrumentación , Insulina/uso terapéutico , Masculino , Persona de Mediana Edad , Obesidad , Estudios Prospectivos , Factores de TiempoRESUMEN
Preliminary results of an observational study are described in 50 unselected diabetic patients treated with insulin pens. The study was conducted to detect the presence of unexpected material in needles and cartridges after a single insulin injection. The injection was done by a trained nurse with the patient's usual pen and insulin cartridge. Cytopathological examination was performed on the material obtained from the needles and found in cartridges after centrifugation. Non-inert material was found in 28% of needles and 58% of cartridges, including squama (18 and 50% respectively) and epithelial cells (20 and 42% respectively). These data, which suggest a non-passive capture of biological material into the delivery system after injection, emphasise the rule of strictly individual use of insulin delivery systems, including cartridges. The precise impact of self-injection of this non-inert material on individuals during repeated pen injections remains uncertain.