Are there other devices to inject insulin?

InsYes. There are other devices to inject insulin. The devices are developed with the aim of reducing the injection related pain as well as make the device easy to carry during travel. Majority of people suffering from diabetes use syringe and disposable needles to inject insulin. However, there are devices which are more convenient.

• Insulin pens – An insulin pen is a handy device that looks like a cartridge pen. As it is the size of a pen, it is very convenient to carry. Some pens use replaceable cartridges of insulin and other models are disposable. The tip of the pen has a fine, short needle. It has a dial to select the desired dose of insulin after which a plunger on the end is pressed deliver the insulin.
• Insulin jet injectors – Jet injectors are useful for people who are scared of needles. The injectors produce a fine spray of insulin and deliver it through the skin by a high-pressure air mechanism instead of needles. The device needs maintenance through boiling and sterilizing. Another drawback of this device is that it is very expensive.
• External insulin pumps – Insulin pumps are external devices that are feather weight and can be carried in pocket or worn around abdomen. The device delivers a pre-feeded insulin amount through narrow, flexible plastic tubing that ends with a needle inserted just under the skin near the abdomen. Users 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. While using insulin pumps, it is very important to monitor the blood sugar frequently so that right dose of insulin can be calculated. These pumps can be expensive to buy and maintain.
• Inhaled insulin - Insulin in inhaled form will soon be available in market. This type of insulin can be inhaled by puffs like any other respiratory inhalers. It is absorbed quickly through the lungs. Inhaled insulins can eliminate the need for injected insulin.

back to index

What is insulin pump?

DiaAn insulin pump is made up of a pump reservoir, like a regular syringe filled with insulin, a small battery operated pump and a computer chip that allows the user to control exactly how much insulin the pump delivers. It is all contained in a plastic case about the size of a beeper.

The pump reservoir delivers insulin to the body by a thin plastic tube called an infusion set. The set has a cannula at the end, through which the insulin passes. The cannula is inserted just under the skin, usually on the abdomen. The infusion set is changed approximately every two to three days. The pump is intended to be used continuously and delivers insulin 24 hours a day according to a programmed plan unique to each pump wearer. A small amount of insulin is given continually. This insulin keeps blood glucose in the desired range between meals and over night. When food is eaten, the user programs the pump to deliver a bolus dose of insulin matched to the amount of food that will be consumed.

Advantages of insulin pumps

• Pumps use faster-acting insulin which is much more predictable than long-acting insulin.
• The Pump delivers insulin in micro-drops that are continuous and accurate.
• You can eat when you want.
• Live a more normal life

back to index

Are there any other ways to take insulin apart from injections?

DiabeYes. There are alternative routes of taking insulin apart from injections. The methods are less painful and may lead to better patient compliance and improved glucose control. However, these routes are less utilized as there are barriers of absorption of insulin.

• Intranasal insulin
  Intranasal insulin can be used for preprandial dosing. While intranasal insulin has been shown to achieve significant decreases in plasma glucose concentrations, its bioavailability is poor, and the dose needed to reach glycemic control markers is significantly higher than for insulin that is administered subcutaneously.
• Oral insulin pills
  Oral insulin has always been an attractive but untenable concept, because insulin is broken down in the digestive system. Research has focused on overcoming this limitation by stabilizing the degradation, improving the permeability, and adding absorption promoters to protect the insulin as it passes through the stomach.
• Buccal/sublingual spray
  The buccal inhaler delivers a high-pressure stream of insulin to the back of the throat. Like the nasal mucosa, the buccal mucosa offers limited surface area. Because the mucosa has low permeability, many puffs may be required for effective dosing.
• Pulmonary or inhaled insulin
  It is the most promising alternate route for insulin delivery because the lung has anatomic advantages over the upper airway. With each branching of the bronchi, the mucosa becomes thinner. By the time the honeycomb-like structures of the alveoli are reached, the surface area available for uptake is tremendous. The inhaled insulin may soon be available for patient use.
• Insulin patch
  The insulin patch for transdermal administration is still undergoing pharmacologic investigation. A 24-hour patch providing a needle-free basal insulin supply is the goal. One problem in developing the patch is that insulin does not easily pass through the skin due to its high molecular weight.
• Other methods
  Additional delivery routes for insulin that have been tried in the research setting include nasal, ocular, rectal, and oral administration. However, due to poor absorption, low bioavailability, or barriers such as active proteolytic enzymes, these routes of administration are not practical at this time.

back to index

What are the recent advances in diabetes medication?

The pharmacological management of type 2 diabetes has changed spectacularly in the past few years with the introduction of many new medications, including [Alpha]-glucosidase inhibitors, a biguanide, the thiazolidinediones, insulin analogs, meglitinides, and d-phenylalanine derivatives. These new agents have dramatically increased the number of alternatives available to providers and patients. Combination therapy has become commonplace for the management of hyperglycemia in patients with type 2 diabetes.

The past few years have brought several new products to market that are useful in the management of type 2 diabetes. The glyburide/metformin combination and the extended-release metformin formulation may be useful for many patients because of their ease of compliance.

The new insulin secretagogue nateglinide is an oral medication that effectively normalizes first-phase insulin response, thus controlling postprandial hyperglycemic excursions without causing a high rate of hypoglycemia. Recent data have also demonstrated that glimepiride may offer some distinct advantages over the other sulfonylureas.

Two new insulin products, aspart and glargine, offer distinct characteristics that will make them optimal choices in certain situations. Aspart, a rapid-acting analog, is useful in controlling postprandial hyperglycemic excursions, whereas glargine offers the first true basal analog. A single injection of glargine provides continuous infusion of insulin into the bloodstream for a 24-h period.

back to index

What are insulin pills?

Insulin pill is one of the ways to administer insulin from outside the body. However, giving insulin through pill is practically difficult as insulin gets broken down in the stomach making it ineffective. So, it would need to be sufficiently coated to make it through the stomach and still be effective. Also, the amount of insulin that can be put in a pill is small compared to what can be delivered in a syringe. Recent researches report promising results in an initial human test of a pill, which could eventually replace the needle for people with mild diabetes, or to provide a quick-acting dose of insulin just before a meal.

back to index

Will I have to always take pills/insulin?

Patients with type I diabetes do not produce insulin in their body. As a result, insulin needs to be given from outside the body lifelong. On the contrary, patients with type II diabetes can eliminate the need of insulin through proper control of blood sugar by diet and exercise.

back to index

What is skin patch?

The insulin skin patch is a non-invasive method of taking insulin. It could complement other forms of insulin delivery. The skin patch involves a two-step process. First, an electronic adhesive patch, powered by a small battery, is applied to the skin; in a millisecond, it painlessly vaporizes cells on the skin surface, creating microscopic openings. Then a small patch, containing a reservoir of insulin, is applied to the skin. Insulin is steadily absorbed into the body during 12 hours of wear.

back to index

What is oral spray?

An alternative to injected insulin is a mouth spray containing insulin that would be absorbed through the lining of the mouth and throat. The insulin oral spray looks like the metered dose inhalers used by people with asthma, but it has been modified so that a liquid aerosol version of insulin, is absorbed by the mucous membranes in the cheeks, tongue, and throat. The benefit from oral spray is identical to an insulin injection in its ability to lower blood glucose levels. Further, it is able to serve as the mealtime boost needed by some people who are failing oral hypoglycemic drugs.

back to index

What is inhaled insulin?

Inhaled insulin system deliver a dose of insulin, either in liquid or dry powder form, through the mouth, directly into the lungs, where it enters the blood circulation as rapid-acting insulin. The advantage with inhaled insulin is that the highly permeable alveolar epithelium and large surface area of the lungs provide an effective, efficient portal for macromolecular delivery. The total alveolar surface area in an adult is more than 70 times greater than the surface area of the entire body.

However, unlike inhaled medications for asthma or chronic obstructive pulmonary disease, insulin doses must be delivered precisely to avoid acute hypoglycemia. Neither nebulizers nor metered-dose inhalers are effective for alveolar insulin delivery. In addition, it is necessary to overcome the lungs' ability to filter particles.

back to index

What is glucose monitoring?

People with diabetes who take insulin or oral medications must monitor blood glucose levels in order to determine whether treatment goals are being met and to make sure that your medication dosage is correct. Blood glucose monitoring is a measurement of glucose in the blood that can be done at any time on a portable machine. It can be a self-test for the diabetic. The finger is pricked and a drop of blood is put on a reagent strip, which uses a chemical substance to react to the amount of glucose in the blood. The meter then reads the strip and displays the results as a number on a digital display. Newer monitors can use blood from other areas of the body besides the fingers, reducing discomfort.

The test allows the diabetic to carefully monitor blood glucose levels to assure that they are within the normal range. The individual can then respond quickly to high or low blood sugar levels with appropriate intervention. This test can also be a screening test for blood glucose levels.

back to index