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Insulin
Delivery
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DEVICES FOR TAKING INSULIN
In addition to syringes, other devices
have been developed to administer insulin as companies seek to improve patient
comfort and convenience. Here we will look at the following types of devices:
- Syringes
- Insulin pens
- Injection aids
- Jet injectors
- External insulin pumps
- Implantable Insulin Pumps
- Insulin Inhalers
Syringes
Most people who use
insulin inject it under the skin (subcutaneously) with a needle and syringe. A
variety of syringes are available in a range of sizes of needle gauge, needle
length and syringe capacity. You should choose the capacity based on your
dosage:
|
If you take 30 units or less . . . use the 3/10 cc
syringe |
|
If you take 50 units or less . . . use the ½ cc syringe
|
|
If you take up to 100 units . . . use the 1 cc syringe
|
Choose a
needle gauge and length that is most comfortable for you:
|
Gauge
- The larger the gauge, the finer the needle |
|
Length -
Children usually find the shorter needle more comfortable, but
people who are overweight need the longer ones. Check with your diabetes
educator or physician, since the needle length can affect absorption of
insulin. |
Check
price and availability at your local pharmacy or diabetes supplier, and select
the one that you are most comfortable using.
SYRINGES FOR ADMINISTERING INSULIN
| Capacity |
Gauge |
Size |
Brand
names/Manufacturers |
1
cc
1/2 cc
3/10 cc |
28,
29,
30G |
1/2", 5/16",
3/8" (3/10 cc only) |
Precision (Abbott), Ultra Thin (Aimsco), Ultra-Fine,
Micro-Fine (BD), Monoject (Can-Am Care),
Lite Touch (Medicore),
UltiCare (UltiMed), ReliOn (Wal-Mart) |
Insulin Pens
Insulin pens are handy if you want
the convenience of carrying insulin with you in a discreet way. Some pens use
replaceable cartridges of insulin; other models are disposable. The tip of the
pen has a fine, short needle. Users turn a dial to select the desired dose of
insulin and press a plunger on the end to deliver the insulin.
INSULIN PENS
| Brand
Name |
Capacity |
Comment |
Autopen
(Owen
Mumford) |
4
models: delivers 1-16
or 2-32 units in 1-unit
increments |
Automatic side injection button;
use with any 1.5
or 3-ml insulin
cartridge |
BD
Pen and BD Pen Mini
(BD) |
Deliver 1 - 30 units in 1-unit
increments, or 1/2
to 15 units
in ½-unit increments (Mini) |
Use
with all 150-ml insulin
cartridges; BD Original and
BD Ultra-Fine
II Short Pen
Needles |
Disetronic Pen
(Disetronic) |
Delivers 1 - 80 units in
1-unit
increments |
Permits use of any type,
manufacturer, or mixture
of insulin,
in disposable 3.15 ml cartridges |
Humalog Pen
Humulin Pen
Humulin N
Pen
(Lilly) |
Holds 300 units; delivers
in 1-unit
increments |
Disposable; prefilled with N,
lispro,
mixtures |
Humalog Mix 75/25
Humulin 70/30 Pen
(Lilly) |
Holds 300 units; delivers
in 1-unit
increments |
Use
with 1.5-ml cartridges |
NovoPen 1.5
(Novo
Nordisk) |
Delivers 1 - 40 units in
1-unit
increments |
Use
with Novolin PenFill 1.5-ml
cartridge and NovoFine 30
disposable
needles |
NovoPen 3
(Novo
Nordisk) |
Delivers 2 - 70 units in
1-unit
increments |
Use
with Novolin PenFill 3-ml
cartridges (available in regular, NPH, and 70/30) and
NovoFine 30 disposable needles |
Novolin Prefilled
(Novo
Nordisk) |
Delivers up to 58 units in
2-unit
increments |
Disposable; prefilled with N, regular,
70/30; use
with NovoFine 30
disposable needles |
Top of page
Injection Aids
A number of devices have been
developed to facilitate injections. They work with most syringes. Other aids are
intended for those who are visually impaired.
INJECTION AIDS
Brand names/
Manufacturers |
Description |
Autoject (Owen Mumford)
Automatic Injector (BD)
Inject-Ease (Palco) |
Spring-loaded plastic syringe holders; position over
skin,
press against site of injection, push button to insert
needle |
Hypoviewer
(HypOview) |
Syringe magnifier and light; enables user to
see
calibrations, air bubbles |
Instaject
(Medicool Inc.) |
Combination lancet and syringe
injector |
Insuflon
(MEDgenesis) |
Infusion set, with a flexible indwelling
catheter; insulin is
injected through an external port |
Insul-eze
(Palco) |
Syringe and bottle
holder; magnifies markings |
Magni-Guide
(BD) |
Syringe and vial holder;
magnifies markings |
Monoject Injectomatic
(CanAm Care) |
Similar to above, but
made of metal instead of plastic |
Syringe Magnifier
(Apothecary
Products) |
Clips onto syringe barrel |
Tru-Hand
(Whittier
Medical) |
Bottle holder with syringe guide; enables change of
bottle without removing syringe; magnifies
markings |
Top of page
Insulin Jet Injectors
Insulin jet injectors send a fine
spray of insulin through the skin by a high-pressure air mechanism instead of
needles. These are great for people who fear needles, but they're expensive and
you have to boil and sterilize the units frequently.
JET INJECTORS
| Brand Name |
Capacity |
Comment |
AdvantaJet
(Activa) |
0.5 - 50 units in 1/2
unit
increments |
Different models available for children and
patients with tough skin |
Injex 30
(Equidyne ) |
5 - 30 units |
Use with disposable ampule |
Medi-Jector EZ
(Medi-Ject Corp) |
2 - 50 units in 1/2
unit
increments |
Children's model available |
Vitajet 3
(Bioject
Corp) |
2 - 50 units in 1/2
unit
increments |
Disposable |
Top of page
External Insulin
Pumps
Insulin pumps are available for
continuous subcutaneous delivery of insulin. Many find these to be an accurate,
precise and flexible insulin delivery system that helps them maintain excellent
glucose control.
External insulin pumps consist of a
reservoir for insulin, a small battery-operated pump and a computer chip that
controls insulin delivery, all in a case about the size of a deck of cards. It
is connected to narrow, flexible plastic tubing that ends with a needle inserted
just under the skin near the abdomen. This infusion set is changed every few
days. The insulin pump weighs about 3 ounces and can be worn on a belt or in a
pocket. Pumps are either waterproof or water-resistant with a waterproof
cover.
Users can set the pump to give a
steady trickle or 'basal' amount of insulin continuously throughout the day.
Most pumps have the option for setting several rates. Pumps release bolus doses
of insulin at meals and at times when blood sugar is too high, based on the
user's programming. Studies have shown that pump therapy can improve glucose
control, particularly for those seeking tight control.
If you use an insulin pump, it's
really important to monitor your blood sugar frequently so you can determine the
right dose and also to be sure that the insulin is being delivered. Many
insurance plans cover the cost of the pump and supplies.
EXTERNAL INSULIN PUMPS
| Brand Name |
Description |
Alarms |
Power
source/
Battery life |
Size |
Animas
R-1000
Animas
R-1000A
(Animas) |
Basal dose every
3 minutes
0.1 - 4.9 u/hr in 0.1 u
increments
0.1 - 9.9 u/hr in 0.5 u
increments |
Occlusion, near empty |
4 1.5-volt
silver oxide
batteries |
3.5" x
3.3"
x
0.7";
3.5 oz |
D-Tron
(Disetronic Medical
Systems) |
2 basal profiles, delivered every 3
minutes in doses as small as .005 unit; 5 bolus alternatives,
rapid delivery
(5 sec/unit)Cartridge design |
Occlusion, system error |
Lithium power supply |
4.2" x
1.9" x
0.9";
4.2
oz |
H-Tron
V100
(Disetronic
Medical Systems) |
Uses U-100 only
Basal
dose delivered
every 3 minutes Bolus dose 0.1 - 25 in
increments of 0.1, 0.2, or 0.5 units |
Low battery, low
cartridge, pump stopped, automatic
off, pump due for
inspection |
2 3-volt silver oxide
batteries; 8 weeks' battery life |
3.6" x 2.16"0 x
0.75"; 3.5 oz |
MiniMed 508
(MiniMed) |
Basal dose varies
Bolus dose 0 - 35 in
increments of 0.1 u |
Near-empty and
empty |
3
1.5-volt
silver oxide
batteries; 4-6 weeks' battery
life |
3.4"
x
1.9" x
0.8";
3.5 oz |
Top of page
Implantable Insulin
Pumps
Researchers are working hard to
develop an implantable insulin pump that can measure blood glucose levels and
deliver the exact amount of insulin needed. Pumps in development are disk-shaped
and weigh 6-8 oz. They are surgically implanted and can be programmed to deliver
a basal dose continuously and bolus doses when needed.
Top of page
Insulin Inhalers
As another alternative to injections,
a variety of insulin inhalers are under development, and some are getting
closer to becoming available on the market. Some use compressed air to convert a
dose of dry or dissolved rapid-acting insulin into particles that can be
inhaled (a process called aerosolization). Others are breath-activated. The
doses are inhaled through the mouth directly into the lungs, where it is easily
absorbed and passes quickly into the bloodstream.
Because most of the models use
rapid-acting insulin, they are intended for use before meals, and will not
totally replace injections. However, investigation of the inhalation of fast-
and slow-acting insulin is also under way. Researchers who are comparing the
effectiveness of the new devices to insulin injections are reporting that they
are successful in delivering insulin and in controlling blood glucose levels.
Some of the questions that are still
being researched for these devices include: Will long-term use of inhalers
irritate the lungs? Will they be effective in a person with a cold or other
respiratory disorder? Precise measuring techniques for dosing and delivery must
also be perfected.
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