Insulin Therapy Changing With Improved Insulin Delivery Methods

Not that long ago, being insulin dependent meant carrying around a syringe and a vial of insulin to deliver your insulin injections, while making sure to keep the insulin dose refrigerated. There are now a variety of methods for insulin delivery on the market, and some promising new developments on the horizon. These include:

1) Insulin pens. Most types of insulin are now available in convenient prefilled pens. Some pens are entirely disposable when empty, and others use a replaceable insulin cartridge, usually containing 300 units. There is a dial on one end to set your desired dose. The pens offer discreet, push button insulin delivery. Some claim the injections are more comfortable than from a needle that has already been dulled by insertion into a vial. Many people prefer to use a pen if they are caring for a diabetic child or pet.

2) Insulin pumps. Insulin pumps are a device about the size of a pager that adhere to the skin and are worn 24/7. Pumps contain an insulin reservoir, a battery powered pump, and a programmable computer chip that allows the user to control insulin dosing.

The pump is attached to a thin plastic tube called a cannula, which is inserted just under the skin to deliver insulin subcutaneously and continuously. Pump technology is constantly being improved upon. The newer pumps are smaller, and can “communicate” and interact with a continuous blood glucose monitor and computer software for state of the art blood sugar control.

3) Insulin jet injectors. Jet injectors deliver a fine jet of high pressure medication directly through the skin. The main advantage is that that the delivery system requires no needles. The major disadvantage is that many diabetics find the force required for the insulin to permeate the skin is painful, and may cause bruising. Jet injectors have been on the market since 1979, but have yet to become popular.

4) Insulin patch. The FDA has just approved a new insulin delivery patch. The new device, Finesse, is a small plastic patch-pen roughly 2 inches long and an inch wide that is attached to the skin like a bandage. It can be worn under your clothes, and remains attached during routine activities like sleeping, exercising and even showering.

Patients use a syringe to pre-fill the patch-pen with a three-day supply of insulin, and simply push two buttons to dispense a dose of fast-acting insulin when needed. The insulin is delivered in seconds through a miniature, flexible plastic tube inserted painlessly into the skin. The manufacturer, Calibra is also working on a patch-pen that would deliver a.05 unit insulin dose for children.

5) Inhaled insulin. The FDA approved the first insulin inhaler, Exubera, in 2006. It was a short-acting insulin delivered to the lungs through a device similar to an asthma inhaler. But it never achieved market success, and was discontinued a year later.

But research on inhaled insulin continued, and two new forms are poised to hit the market. One is an inhaler, AFREZZA, which is awaiting FDA approval. The other is a spray which is absorbed through the mouth, called Oral-Lyn. Oral-Lyn is in Phase 111 clinical trials in Europe and North America.

Despite some obvious advantages to the new insulin delivery methods, tried and true syringes remain the most popular way to deliver injections with most insulin dependent diabetics, who no longer consider them a big deal.

Insulin pens, pumps, and jet injectors are all more costly than insulin syringes, and not always covered by medical insurance. Not all types of insulin are available in insulin pens, and you can’t mix insulin types in a pen.

Insulin pumps can kink or otherwise malfunction, posing the danger of inaccurate insulin dosing, and are just too “high tech” for some diabetics. Many diabetics remain skeptical of devices like inhalers and sprays after Exubera’s spectacular lack of success.

Still, with the advances being made in insulin pumps, and the pending introduction of an improved inhaled insulin and the insulin patch, the world of insulin therapy is definitely changing – and most would say for the better.