根据一项涉及全球16个国家、171个中心的研究结果显示，我国只有不到一成的患者掌握了正确的胰岛素注射技术，直接导致我国已经使用胰岛素治疗的患者中只有37%的患者血糖达标率，中华医学会糖尿病学分会常委、北京大学第一医院内分泌科主任郭晓蕙教授表示。

According to a global in 16 countries/171 center study shows,Our country is only less than ten percent of the patients master the correct insulin injection technology,Our country has led directly to the use of insulin therapy in patients with only 37% of patients blood sugar percentage,The Chinese medical association of diabetes learn branch/The first hospital, Beijing university, director of the endocrinology GuoXiaoHui professor said.

规范注射 “针”成问题 Standard injection "needle"problem

　　“注射部位轮换不规范、重复使用注射笔用针头、注射手法错误以及患者教育的缺失是目前胰岛素注射中存在的普遍问题。” 中华医学会糖尿病学分会副主任委员、解放军总医院内分泌科主任陆菊明教授指出，“以注射笔用针头为例，目前市场上的胰岛素笔用针头和胰岛素注射器都是按照一次性使用的标准设计制造的，胰岛素注射治疗中，应保证胰岛素笔用针头和胰岛素注射器一次一换。重复使用会影响注射胰岛素剂量的精确性，并导致皮下脂肪增生和硬结的产生，从而影响胰岛素的吸收。

"Injection site rotation is not standard/Repeated use injection pens with a needle/Injection technique error and the patient education is the lack of insulin injections of existing in the common problem." The Chinese medical association, vice chairman of diabetes learn/The people's liberation army general hospital endocrinology director professor noted that LiuJuMing,"To injection pens with needles, for example,Currently on the market insulin pen with needles and insulin syringe are according to the disposable use standard of design and manufacture,In the insulin injections,Should ensure insulin pen with needles and insulin syringe one change.Repeated use will affect injections of insulin doses of accuracy,And lead to subcutaneous fat hyperplasia and callous produce,Thus affect the absorption of insulin.

　　记者了解到，天津、浙江、广东等八个省市已经将胰岛素笔用针头纳入当地门诊医保报销范畴。在2012版《全国医疗服务价格项目规范目录》中，已经明确将胰岛素皮下注射单独立项并将胰岛素注射针头列为可单独收费的除外内容的耗材之列，为制定胰岛素笔用针头门诊医保支付政策奠定了坚实的物价收费政策依据。

The reporter understands,tianjin/zhejiang/Guangdong, eight provinces and cities have will insulin pen with needles into local clinic medical insurance expense category.In the 2012 edition[The national medical service price project standard directory]in,Has clear will insulin subcutaneous injection project alone and insulin injection needles can be listed as an individual fee except the content among the consumables,Formulated with needles for insulin pen of outpatient service medical insurance payment policy has laid a solid price fare policy basis.

简化流程 “针”重要 Process is simplified "needle"important

　　接下来，中华医学会糖尿病学分会将在全国范围内开展“ITQ糖尿病规范注射技术调查问卷活动”，旨在了解医护对于规范注射认识和重视度，以及患者对于规范注射的掌握现状，从而发现治疗需求，推进注射技术在中国的发展，帮助更好地血糖控制。该活动将覆盖全国十几个城市，50家医院。

The next,The Chinese medical association diabetes learn branch will launch a nationwide campaign"ITQ diabetes standard injection questionnaire activities",To care for standard injection understanding and importance,And the patient to the standard injection control present situation,Thus found that needs treatment,Propulsion injection technology development in China,Help better glycemic control.This event will be covered the whole country of ten cities,50 hospitals.

　　陆教授进一步介绍说，“现在的胰岛素规范注射技术包括9个步骤。其中，注射时正确捏皮的方法以及进针的角度，是很多患者在实际操作中最容易出现错误的环节。如果选择目前广泛使用的4mm或5mm超细超短型的针头，在注射时几乎无疼痛感，注射时大多数情况下无需捏起皮肤，单手操作即可。这将使规范注射流程进一步简化，在方便糖尿病患者的同时，也使注射更准确、更安全、更舒适，客观上为不断提高糖尿病患者的依从性和规范操作性提供了基础。”

Professor lu further said,"Now the standard insulin injection technology including nine steps.the,When injection method and correct knead skin into needle point of view,Many patients in the actual operation is the most vulnerable to mistakes link.If choose at present the extensive use of 4 mm or 5 mm superfine ChaoDuanXing needles,In the injection almost no pain,Injection, most cases need not knead the skin,Single hand operation can.This will make standard injection process further simplified,Patients with diabetes in convenient at the same time,Also make more accurate injection/safer/More comfortable,Objective to continuously improve diabetes patient compliance and standardize operational provides the basis."

■小贴士 S tip

胰岛素规范注射九步骤 Insulin standard injection nine steps

　　1. 注射前洗手。

1. Wash your hands before lethal injection.

　　2. 核对胰岛素类型和注射剂量。

2. Check the type and dose of insulin.

　　3. 安装胰岛素笔芯。

3. Installation insulin cartridge.

　　4. 预混胰岛素需充分混匀。

4. Premix insulin should be fully blending.

　　5. 安装胰岛素注射笔用针头

5. Installation insulin injections pen with a needle

　　6. 要检查注射部位和消毒。

6. Want to check injection site and disinfection.

　　7. 根据胰岛素注射笔用针头的长度明确是否需要捏皮以及进针的角度。绝大多数成人4mm或5mm针头无需捏皮垂直进针即可。

7. According to the insulin injection pens with the length of the needle clear whether to need to knead skin and into the needle point of view.The vast majority of adult 4 mm or 5 mm needle need not knead skin vertical into needle can.

　　8. 注射完毕以后，针头滞留至少10秒后再拔出。

8. After the injection,Needle retention at least 10 seconds after out again.

　　9. 注射完成后立即戴上外针帽将针头从注射笔上取下，丢弃在加盖的硬壳容器中。

9. Injection immediately after put on external needle cap will needle injection pen from the take off,Discard the capped encrustation containers.

■新闻链接 S news link

中国糖尿病患者应特别关注餐后血糖 Chinese patients with diabetes should pay special attention to postprandial blood sugar

　　一日三餐对健康人来说再平常不过，但对于糖尿病患者而言，一天超过50%的时间处于餐后状态就意味着每天12个小时需要注意餐后血糖的控制。而在中国，这种情况尤为突出。一项发表在新英格兰杂志的流行病学调查结果显示，中国新诊断的2型糖尿病患者中餐后血糖升高的比例超过80%。对此，中日友好医院内分泌代谢病中心主任杨文英教授表示：“与欧美人相比，中国患者餐后血糖升高的比例更高，达到80%以上。餐后血糖控制不好，糖化血红蛋白就很难达标，而糖化血红蛋白是导致多种糖尿病并发症的罪魁祸首。为降低并发症的发生危险，中国糖尿病患者应特别注意餐后血糖达标。”

Three meals a day to healthy people even more commonplace,But as in diabetic patients,One day more than 50% of the time in postprandial state means that every 12 hours need to pay attention to postprandial blood glucose control.In China,This kind of situation is particularly prominent.One published in the New England journal of epidemiological survey,China's new diagnosed type 2 diabetes rise in glucose after lunch the proportion of more than 80%.this,The sino-japanese friendship hospital endocrine metabolic disease center director professor alvarssonm, said:"Compared with the European and American people,Patients with China of postprandial glucose elevated rates higher,Achieve 80% above.After dinner poor blood glucose control,Glycated hemoglobin is difficult to standard,And glycated hemoglobin is lead to a variety of diabetes complications culprit.To reduce the risk of complications,Chinese patients with diabetes should pay special attention to postprandial blood glucose control is at target levels."

　　据了解，中式餐饮中主食所占的比率较大，每餐的碳水化合物摄入在60~65%之间，而西式餐饮每餐的碳水化合物平均不超过50%。杨文英称，我国饮食结构问题也是导致我国糖尿病患者餐后血糖升高的原因之一。而餐后血糖对糖化血红蛋白的影响至关重要，糖化血红蛋白每降低1%，糖尿病相关死亡率降低21%，心肌梗死的发生率降低14%。同时，大量流行病学研究也证明，餐后血糖峰值与心血管事件发生和死亡的相关程度较空腹血糖更高。因此，杨文英认为，为了更好地控制餐后血糖，降低心血管风险，临床也需更多不同配比的预混胰岛素制剂，以满足患者的不同需求。谈到制剂的注射，杨文英表示，调查显示有80%的糖尿病患者未能严格按照标准时间注射，给疗效带来了隐患，针对需要注射灵活的患者来说，临床出现的可以临餐注射的制剂更为方便、安全。　(记者 接贵云 邵瑞琳)

It is understood,Chinese food in the proportion of staple food larger,Every meal carbohydrate intake in 60 to 65%,And western-style restaurant meals of carbohydrates average no more than 50%.Alvarssonm, says,Our country diet structure in our country is also lead to diabetes postprandial blood sugar one of the reasons for the rise.And postprandial blood sugar to the influence of glycosylated hemoglobin is very important,Glycated hemoglobin every reduced by 1%,Diabetes related mortality by 21%,The incidence of myocardial infarction reduced by 14%.At the same time,A large number of epidemiological studies have also proved,Postprandial blood sugar peak and cardiovascular events and death related degree is higher fasting glucose.therefore,Alvarssonm, think,In order to better control the postprandial blood sugar,Reduce cardiovascular risk,Clinical also need to more different proportion of the premixed insulin preparation,In order to meet the different needs of patients.When it comes to preparation of injection,Alvarssonm, said,Surveys show that 80% of patients with diabetes not in strict accordance with the standard time injection,Brought the hidden danger to the curative effect,According to the need for injection flexible for patients,Clinical appear to the meal injection preparation is more convenient/safety.(Reporters pick your cloud ShaoRuiLin)