Insulin TherapyDevices & Monitoring
RESEARCH SUMMARY

Needle-free insulin injection improves blood sugar control and reduces pain in hospitalized type 2 diabetes patients

Moderate confidence
some concerns bias
Last updated May 7, 2026

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

InterventionOutcomeMeasured ChangeStudy Effect
Devices & Technology
Needle-free injection
(Devices & Technology)
Glycemic Control
Daily insulin dose
(Glycemic Control)
Uncertain
Limited
Devices & Technology
Needle-free injection
(Devices & Technology)
Glycemic Control
Fasting Plasma Glucose
(Glycemic Control)
Decrease
Strong
Devices & Technology
Needle-free injection
(Devices & Technology)
Glycemic Control
Glucose variability
(Glycemic Control)
Decrease
Strong
Devices & Technology
Needle-free injection
(Devices & Technology)
Safety
Hypoglycemia events
(Safety)
Uncertain
Limited
Devices & Technology
Needle-free injection
(Devices & Technology)
Patient-Reported
Injection-associated pain
(Patient-Reported)
Decrease
Strong
Devices & Technology
Needle-free injection
(Devices & Technology)
Safety
Injection-site adverse events
(Safety)
Decrease
Strong
Devices & Technology
Needle-free injection
(Devices & Technology)
Glycemic Control
Postprandial glucose
(Glycemic Control)
Decrease
Strong
Devices & Technology
Needle-free injection
(Devices & Technology)
Glycemic Control
Serum 1,5-anhydroglucitol
(Glycemic Control)
Increase
Strong
Devices & Technology
Needle-free injection
(Devices & Technology)
Glycemic Control
Time in range
(Glycemic Control)
Increase
Strong
Devices & Technology
Needle-free injection
(Devices & Technology)
Glycemic Control
Time to target glucose control
(Glycemic Control)
Decrease
Strong
Devices & Technology
Needle-free injection
(Devices & Technology)
Patient-Reported
Treatment satisfaction
(Patient-Reported)
Increase
Strong

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evidence suggest

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

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

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

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.

1
Guideline

ADA Standards of Care in Diabetes—2024: Insulin and Other Injectable Medications

The American Diabetes Association's clinical practice guidelines provide evidence-based recommendations for pharmacologic approaches to glycemic treatment, including intensive insulin therapy regimens for patients with type 2 diabetes who have significantly elevated HbA1c or inadequate control on oral medications.
2
Guideline

A Guide for People with Type 2 Diabetes | American Diabetes Association

American Diabetes Association resource matched by keyword relevance (type 2 diabetes)
3
Guideline

AACE Consensus Statement: Algorithm for Management of Adults with Type 2 Diabetes – 2026 Update | American Association of Clinical Endocrinology

This updated algorithm provides evidence-based visual guidance in graphic algorithms and a summary of evidence and considerations to assist health care professionals with the diagnosis and management of adults with prediabetes and type 2 diabetes in shared decision-making to improve care.

13 total sources in this category

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