Needle-free insulin injection improves blood sugar control and reduces pain in hospitalized type 2 diabetes patients
Key takeaway:
A 12-day study in 63 hospitalized type 2 diabetes patients found that needle-free insulin injection achieved better blood sugar control, reduced glucose swings, and caused less pain than conventional insulin pens.
Study at a glance
What was studied
Needle-free insulin injection compared to conventional insulin pens in hospitalized type 2 diabetes patients
Study type
Randomized Controlled Trials (RCTs)
duration
Short-Term (≤3 mo)
Intervention
Needle-free injection
Outcomes
Fasting Plasma Glucose, Postprandial glucose, Time in range, Glucose variability, Serum 1,5-anhydroglucitol, Time to target glucose control, Hypoglycemia events, Injection-site adverse events, Injection-associated pain, Treatment satisfaction, Daily insulin dose
Funding
Non-industry sponsored
Main effects
↓ Fasting plasma glucose (mean reduction 7.24 mmol/L in NFI vs 5.82 mmol/L in CIP, p<0.05)
↓ Postprandial glucose (mean reduction 8.65 mmol/L in NFI vs 6.68 mmol/L in CIP, p<0.05)
↑ Time in range (83.6% in NFI vs 76.8% in CIP, p<0.01)
Evidence Summary
| Intervention | Outcome | Measured Change | Study Effect |
|---|---|---|---|
Needle-free injection (Devices & Technology) | Daily insulin dose (Glycemic Control) | Uncertain | Limited |
Needle-free injection (Devices & Technology) | Fasting Plasma Glucose (Glycemic Control) | Decrease | Strong |
Needle-free injection (Devices & Technology) | Glucose variability (Glycemic Control) | Decrease | Strong |
Needle-free injection (Devices & Technology) | Hypoglycemia events (Safety) | Uncertain | Limited |
Needle-free injection (Devices & Technology) | Injection-associated pain (Patient-Reported) | Decrease | Strong |
Needle-free injection (Devices & Technology) | Injection-site adverse events (Safety) | Decrease | Strong |
Needle-free injection (Devices & Technology) | Postprandial glucose (Glycemic Control) | Decrease | Strong |
Needle-free injection (Devices & Technology) | Serum 1,5-anhydroglucitol (Glycemic Control) | Increase | Strong |
Needle-free injection (Devices & Technology) | Time in range (Glycemic Control) | Increase | Strong |
Needle-free injection (Devices & Technology) | Time to target glucose control (Glycemic Control) | Decrease | Strong |
Needle-free injection (Devices & Technology) | Treatment satisfaction (Patient-Reported) | Increase | Strong |
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Evidence Suggest
- Needle-free insulin injection achieved significantly better glycemic control than conventional insulin pens during short-term intensive therapy
- Glucose variability was reduced with needle-free injection, as shown by higher time in range and lower glycemic excursion amplitudes
- Needle-free devices caused substantially less injection pain and improved patient satisfaction without increasing hypoglycemia risk
Who this applies to
This study enrolled hospitalized adults aged 18-70 with type 2 diabetes requiring intensive insulin therapy, including newly diagnosed patients with HbA1c ≥9% or FPG ≥11.1 mmol/L, or those with persistent poor control despite 3 months of oral medications. Average participants were in their early 40s, overweight, and had moderately high baseline glucose levels.
Keep in Mind
This was a very short study in a hospital setting with intensive monitoring that may not reflect real-world outpatient use. The open-label design means participants and staff knew which device was being used, which could affect subjective outcomes like pain and satisfaction ratings. Longer studies are needed to determine if these benefits persist over months or years and whether needle-free devices improve long-term adherence and outcomes. The study also didn't assess cost-effectiveness or device availability issues.
Between the Lines
- Very short study duration (12 days) limits understanding of long-term effectiveness and sustainability
- Small sample size (63 participants) from single hospital reduces generalizability
- Conducted only in hospitalized patients, unclear if results apply to outpatient settings
- Open-label design may have influenced subjective outcomes like pain and satisfaction
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Journal Reference
Wang J, Liu Z, Jiao L, et al. Efficacy and safety of needle-free injection in patients with type 2 diabetes mellitus undergoing intensive insulin therapy: a randomized controlled trial based on the flash glucose monitoring system. Front Endocrinol (Lausanne). 2026;16:1652388. doi:10.3389/fendo.2025.1652388
Sources
Ranked by clinical relevance and evidence quality.
Key References
Most relevant evidence and guidance related to this research.
ADA Standards of Care in Diabetes—2024: Insulin and Other Injectable Medications
AACE Consensus Statement: Algorithm for Management of Adults with Type 2 Diabetes – 2026 Update | American Association of Clinical Endocrinology
Supporting Evidence
Supporting evidence and related resources.
AACE Releases 2023 Type 2 Diabetes Management Algorithm to Support Clinical Decision Making | American Association of Clinical Endocrinology
Abaloparatide Followed by Alendronate Shows Promising Results for Women With Osteoporosis, T2D | American Association of Clinical Endocrinology
Cardiovascular Effects of Canagliflozin Vary According to Concomitant Metformin Use | American Association of Clinical Endocrinology
CDC - Insulin Routines
FDA - Insulin Delivery Devices
Efficacy and Safety of Luseogliflozin in Patients with Type 2 Diabetes Mellitus: An Umbrella Review of Systematic Reviews.
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