Blood Glucose

Insulin Delivery Systems

January 11, 2017   /

Many options are available to deliver insulin to your body, and scientists are continuing to work on a number of new options for insulin administration. This article will help you understand the systems that are available today. Although these systems differ, they all provide the same function—sending insulin to your body.

Your health care team can help you choose the insulin delivery system that will best meet your needs, based on how active you are, your age, and when and where you take your insulin.

Vial and syringe
The vial and syringe is still the most popular form used in America:

  • Needle:
    • Placed under the skin to deliver the insulin
    • Usually injected into thighs, buttocks, or abdomen
    • Has special coatings to make injections painless (most brands)
    • Are relatively inexpensive
  • Length of needle will impact the absorption of insulin
  • Syringes allow for mixing of different types of insulin
  • Needle guides and vial stabilizers hold the vial and syringe together when filling with insulin
  • Insertion aids are spring-loaded to hide the needle from view until the plunger is pushed, at which time the needle is inserted into the skin—especially good for people with needle anxiety
  • People with visual or physical impairments may have a difficult time
  • Syringe magnifiers available to enlarge the calibration marks on the syringe
  • Risk of inaccurate dosing, because dose not premeasured; adequate mixing of suspensions is crucial
  • Less discreet than insulin pens

Jet injectors
Instead of a needle, a high-pressure stream of insulin penetrates the skin:

  • Most appropriate for people with severe needle anxiety
  • Bruising and permanent skin discoloration may occur
  • More expensive than vial and syringe
  • Not well studied in clinical trials
  • Jet injectors look like a large pen, but may seem cumbersome and mechanically complex

Insulin pens and dosers
Insulin pens and dosers often are used for multiple daily doses of insulin:  

  • The insulin pen holds a cartridge with insulin and has a small needle at the tip
  • The user sets the appropriate dosage by moving a dial on the side of the pen
  • A plunger is used to inject the insulin
  • Very convenient and discreet
  • Consistent dosage is delivered
  • Limited to premixed formulations and do not allow for mixing of different types of insulin
  • Pens are much more accurate than vial and syringe for small doses of insulin (less than 5 units), but about equal for higher doses
  • Many people think pens are much easier to use than vial and syringe
  • Some pens are disposable; others are reusable (durable)

Insulin pumps
This delivery system pumps insulin continuously through plastic tubing attached to a needle under the skin near the abdomen:

  • The pump is small enough to wear on a belt or place in a pocket
  • Programming allows delivery of both basal and bolus doses
  • Removal of the pump for up to 1 hour is allowed for activities such as swimming, showering, etc 
  • Of all options, most suitable for reaching intensive treatment goals
  • Very precise insulin doses provided throughout the day
  • Discrete
  • Insulin pumps allow for a flexible lifestyle
  • Initially very expensive
  • Sometimes inflammation and infection develop at site
  • Kinking of catheter, battery failure, or mechanical malfunctioning are possible (all pumps have an alarm that sounds when an interruption in the delivery of insulin occurs)
  • Individuals using insulin pumps need to learn to make adjustments when blood glucose readings are out of line, for exercise, following a large meal, etc 
  • Necessary to check blood glucose frequently
  • A1c is lowered in pump users
  • Often a very good choice for children
  • Many pumps contain food databases and carbohydrate calculators
  • Insulin pumps can provide up to four basal routines, with variations for sick days or weekends

Buccal
Delivered into the mouth by a “spray” of insulin (like a can of spray paint):

  • This works about as well as inhaled insulin did, before Exubera® was removed from the market
  • More expensive than inhaled

Infusers
Insulin goes right through the infuser and into your body—no needles are necessary:

  • A hole is made in the skin, where you can inject insulin
  • A needle or tiny tube is inserted right under the skin and taped in place
  • Sites are changed every 2–3 days

 

References and recommended readings

American Diabetes Association®. Insulin routines. Available at: http://www.diabetes.org/living-with-diabetes/treatment-and-care/medication/insulin/insulin-routines.html. Accessed July 24, 2012.

Nitesh SC, Sanjeev C, Vandana H, Alka A, Vijender S. Recent advances in insulin delivery systems: an update. World Applied Sciences Journal [serial online]. 2010;11:1552-1556. Available at: http://www.idosi.org/wasj/wasj11%2812%29/17.pdf. Accessed July 24, 2012.

Steffens R. Generex Biotechnology: Oral-lyn buccal insulin takes center stage. Available at: http://seekingalpha.com/article/71819-generex-biotechnology-oral-lyn-buccal-insulin-takes-center-stage. Accessed July 24, 2012.

Watson S. Insulin delivery systems: an overview. Available at: http://diabetes.webmd.com/features/insulin-delivery?page=3. Accessed May 28, 2012.