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Risks of jet injection of insulin in children
1Department of Paediatrics and Genetics, University Canton Hospital, Geneva, Switzerland.
Insights
Non-invasive insulin injectors offered less pain for diabetic children but caused significant side effects, including hospitalization. This method is not recommended for young children due to safety concerns.
Area of Science:
- Pediatric Endocrinology
- Medical Device Technology
Background:
- Painful insulin injections are a common issue for children with diabetes.
- Alternative insulin delivery methods are sought to improve patient comfort and adherence.
Purpose of the Study:
- To evaluate the efficacy and safety of a non-invasive insulin injector in pediatric diabetic patients.
- To compare metabolic control and injection pain between jet injectors and traditional syringe/needle methods.
Main Methods:
- A study involving ten diabetic children over 1347 days.
- Assessment of insulin dosage, HbA1c levels, injection pain perception, and adverse events.
- Comparison of outcomes between non-invasive jet injectors and conventional syringe/needle injections.
Main Results:
- Jet injections were perceived as less painful by 90% of participants.
- No significant change in mean HbA1c (9.0% +/- 0.5%) or insulin requirements was observed.
- Significant side effects occurred in 80% of cases, including glycoketonuria (60%) leading to hospitalization in 30% of patients.
Conclusions:
- Non-invasive insulin injectors are not recommended for young diabetic children due to frequent and serious adverse events.
- For older children and adolescents, it may be a viable alternative if provided with thorough education and close medical supervision.
Abstract:
The aim of our study was to assess whether a non-invasive insulin injector could improve the metabolic control of ten diabetic children complaining of painful injections with syringe and needle. The cumulative study period amounted to 1347 days. Whereas a non-significant rise in insulin needs was observed (from 0.98 +/- 0.03 to 1.03 +/- 0.06 units/kg per day, mean +/- sem), mean HbA1c value remained unchanged (8.9% +/- 0.4% vs 9.0% +/- 0.5%). Jet injections were felt as less painful than those using syringe and needle (nine out of ten cases). This advantage was hampered by side-effects in eight out of ten cases such as episodes of glycoketonuria (six out of ten cases) leading to hospitalization in three patients. Other side-effects included inability to adjust injection pressure (four out of ten cases) and technical failure requiring an exchange of injector in five cases. The four children with most serious problems were significantly younger (P = 0.009) than other subjects. In conclusion, this type of injector should be discouraged in young diabetic children. For older children and adolescents, it may be an alternative to syringe and needle provided repeated detailed information and tight medical supervision is available.