There are various insulin delivery devices available, which are prefilled with insulin including pens, pumps and inhalers. The major advantages are ease of administration, less pain and provision of more choices for diabetes clients.
Insulin Delivery Devices
Insulin pens are one of the most commonly used insulin devices. They are now available in different shapes and use an insulin cartridge as opposed to a vial. Some insulin pens use replaceable cartridges and hence are reusable with a new cartridges an they must be disposed off after being used.
Prefilled non-reusable pens have built-in, single-use insulin cartridge which is disposable. They have a rotating piston-type dial or dial with digital / manual readout to measure insulin does that may be dialed up or down with accurate dose.
In reusable type of pens, an insulin cartridge is placed into pen’s delivery chamber. This allows greater flexibility ( changing type of insulin without needing to buy another pen if prescription changes). Hence, it may be more economical. In addition to being durable and easy-to-use, they are designed for longer duration use. Now almost all insulin pens use replaceable insulin pen needles. These are extremely short and very thin.
Storage of Insulin Pens
Few important precautions are needed while storage of insulin pens. They are as follows…..
- Insulin cartridge and pens should be stored in the refrigerator before use. It should never be frozen.
- Once a cartridge is placed in a reusable pen, the pen can be kept at room temperature. It should be kept away from direct heat and light.
- Prefilled pens that are in use should not be kept in refrigerator
- Care needs to be taken to avoid over or under dose of insulin near the end o the insulin supply from the pen which is in current use.
- If insufficient insulin is left in pen for current dose, a new pen and second injection is required.
Precautions while using Insulin Pens
Before use of an insulin pen, always remember doctor’s advice and read the manufacturer’s instructions to learn any specific safety precautions that need to be followed.
Following are few additional points…
- Always check whether the insulin in the cartridge is clear not cloudy since that can lead to reduced effect.
- Never carry an insulin pen with the needle attached since that can alter the accuracy of insulin dose and can lead to air inside insulin cartridge.
- Avoid repeated use of same needle as it can cause breakage of needle and more pain during injections.
Insulin pumps are portable computerized devices attached to the body that deliver constant amounts of rapid- or short-acting insulin via a catheter placed under the skin. They deliver insulin in two ways:
- As a steady measured and continuous dose (basal insulin)
- As a surge (bolus) dose, as per patient’s direction, around mealtime.
Insulin pumps are either external, attached to body from outside or internal, which are implanted in the body surgically. External pumps are hard to access and expensive, however, they are accurate, precise and flexible. Implantable insulin pumps are small, extremely discreet and light-weight. They provide continuous basal dose of insulin and a bolus is supplied when required.
Accu-Chek Spirit can maintain the plasma glucose levels at desired levels effectively for the entire day. Few additional characteristics include – the boluses are determined by blood glucose and not by bolus on board (BOB). Pre-programmable bolus increments are present. Accu-Check meter software has low plasma glucose index that may help predict hypo unawareness. It has a strong motor and causes smooth delivery of insulin.
Medtronic paradigm has insulin pump as well as real time continuous glucose monitoring. It is very simple to operate. It has facility to predictive alerts, which warns impending hypoglycaemia 30 minutes before and also ahs facility for missed meal bolus reminder to avoid hypoglycaemia after meals.
Insulin inhalers are already approved by US-FDA for use in patiens of diabetes. They are not currently commercially available in India. These devices use compressed air to give a dose of dry insulin or dissolved rapid-acting insulin that can be inhaled. Most insulin inhalers use rapid-acting insulin, and for this reason they do not totally replace insulin injections. They will be used in combination with long-acting insulin.
Inhalation insulin is not recommended to be used in diabetic patients having asthma or other respiratory diseases. It is also not used in smokers.