Insulin TherapyDevices & Monitoring
Research Summary
Analyzed using Evidence Intelligence™

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

Last updated May 7, 2026

Key finding

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.

This study compared needle-free insulin injectors to traditional insulin pens in hospitalized people with type 2 diabetes needing intensive insulin therapy. After about 12 days, those using needle-free devices had better blood sugar control, less glucose variability, faster achievement of target levels, fewer injection-site problems, less pain, and higher satisfaction without increased low blood sugar episodes.

Quick read

Study at a glance

The essential study design details in one scan.

EvidenceScore™

Moderate

Study type

Randomized Controlled Trials (RCTs)

Follow-up

Short-Term (≤3 mo)

Risk of bias

Some Concerns

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Plain-language summary

What this paper says

A plain-language read of the study’s main message and where it applies.

Study focus

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.

Published in

Journal Reference

Publication details and source links for this paper.

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

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 network

How this study fits

Understand where this research contributes within the broader evidence network.

Evidence Context

This study contributes evidence to Needle-free injection and 1,5-Anhydroglucitol, Glucose variability, Hypoglycemia events, and 6 more.

Primary intervention

Needle-free injection

Primary outcomes

  • 1,5-Anhydroglucitol
  • Glucose variability
  • Hypoglycemia events

Evidence relationships

Intervention and outcome relationships this study adds to the evidence network.

9
Evidence pairs
9
Relationships
2
Evidence topics
contributes_evidence

Editorial context

Why this study matters

See why this paper is useful beyond its individual results.

Evidence network role

This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.

Moderate contributionModerate confidenceNetwork score: 51

2

Related topics

9

Evidence pairs

246

Related studies

High relevance in at least one topic

Why it is useful

  • Contributes to 9 evidence relationships
  • Uses a randomized study design signal
  • Linked to 2 direct semantic evidence topics

Topic contributions

Evidence topic

Contributes evidence

Evidence topic

Contributes evidence

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Primary evidence

Evidence relationship

Insulin Delivery Systems and CGM Time in Range

Related evidence

Evidence relationship

Insulin Delivery Systems and Hypoglycemia

Save evidence

Evidence relationship

Insulin Delivery Systems and Insulin Resistance

Save evidence

Core evidence

Study findings

The primary outcomes reported in this study.

1,5-Anhydroglucitol

Needle-free injection → 1,5-Anhydroglucitol

Needle-free injection → 1,5-Anhydroglucitol

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
100
Very Positive
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Glucose variability

Needle-free injection → Glucose variability

Needle-free injection → Glucose variability

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
100
Very Positive
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Hypoglycemia events

Needle-free injection → Hypoglycemia events

Needle-free injection → Hypoglycemia events

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
55
Slightly Positive
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Injection pain score

Needle-free injection → Injection pain score

Needle-free injection → Injection pain score

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
100
Very Positive
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Injection-site adverse reactions

Needle-free injection → Injection-site adverse reactions

Needle-free injection → Injection-site adverse reactions

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
100
Very Positive
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Time in range

Needle-free injection → Time in range

Needle-free injection → Time in range

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
100
Very Positive
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Time to glycemic target

Needle-free injection → Time to glycemic target

Needle-free injection → Time to glycemic target

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
100
Very Positive
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Total daily insulin dose

Needle-free injection → Total daily insulin dose

Needle-free injection → Total daily insulin dose

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
55
Slightly Positive
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Treatment satisfaction

Needle-free injection → Treatment satisfaction

Needle-free injection → Treatment satisfaction

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
100
Very Positive
ConsistencyScore™
unclear
Not enough independent studies
Supporting studies: Based on 1 study
Add to Evidence Tracker

Evidence Library

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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

Evidence Library

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Connected Evidence

Explore related studies, evidence collections, and research questions.

Relationships organized using the Dediabetes Evidence Intelligence™ framework.

This study contributes to evidence on Insulin Delivery Systems and Insulin Resistance, Insulin Delivery Systems and Glucose Variability.

Related evidence relationships

Explore in Evidence Explorer

This study contributes to the evidence on the following intervention-outcome relationships.

Questions answered by this study

Generated from the study's connected evidence using Evidence Intelligence™.

Does Insulin Delivery Systems improve cgm time in range?

Strong Evidence

Insulin Delivery Systems may improve CGM Time in Range.

ConsistencyScore™: Results are generally consistent across studies.

Ranked evidence signals

  1. 1

    Time in range

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study

  2. 2

    Time to glycemic target

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on 17 supporting studies with generally consistent results and a positive effect signal.

Limitations

  • Population details are unavailable.
17 supporting studiesUpdated: Jul 2026

Does Insulin Delivery Systems affect hypoglycemia?

Strong Evidence

Insulin Delivery Systems may improve Hypoglycemia.

ConsistencyScore™: Results are mixed and should be interpreted cautiously.

Evidence caveat: The available evidence reports mixed findings.

Ranked evidence signals

  1. 1

    Hypoglycemia events

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | weak positive | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is cautious because the available studies report mixed findings.

Limitations

  • Population details are unavailable.
6 supporting studiesUpdated: Jul 2026

Does Insulin Delivery Systems improve insulin resistance?

Strong Evidence

Insulin Delivery Systems may worsen Insulin Resistance or be associated with harm.

ConsistencyScore™: Results are generally consistent across studies.

Ranked evidence signals

  1. 1

    Total daily insulin dose

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | weak positive | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on 3 supporting studies and existing graph evidence signals.

Limitations

  • Population details are unavailable.
3 supporting studiesUpdated: Jul 2026

Does Insulin Delivery Systems improve glucose variability?

Strong Evidence

Insulin Delivery Systems may improve Glucose Variability.

ConsistencyScore™: Results are generally consistent across studies.

Ranked evidence signals

  1. 1

    Glucose variability

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on 7 supporting studies with generally consistent results and a positive effect signal.

Limitations

  • Population details are unavailable.
7 supporting studiesUpdated: Jul 2026
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