Advances in Insulin Injection Research Influences Patient Adherence

Aronson, Ronnie; Bailey, Timothy S.; Hirsch, Laurence; Saltiel-Berzin, Rita

doi:10.17925/use.2013.09.02.114

Cited by 7 publications

(8 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These early needles ranged in length from 19 to 26 mm and were manually sharpened for repeated use against a whetstone by the user. 10,11 Their length and design could evoke anxiety and tension in people with diabetes, especially children.Looking from today's perspective we now understand that these early needles posed substantial risks for IM injections by people self-injecting insulin. 9 In 1985, when the first widely used insulin pen was introduced by Novo Nordisk, the PN length most commonly available was still 16 mm (Figure 1).…”

Section: History Of Innovations In Needle Technologymentioning

confidence: 99%

“…The external diameter of a 32G needle is 0.23 to 0.24 mm, similar to the diameter of a human eyelash. 11 Early imaging studies of the human skin in the 1980s began to raise concerns about needle lengths being longer than measured depths of SC tissue at different body sites, especially at the thigh, with increased risk of IM injection and subsequent variability in insulin absorption. 12,13 At the time, a perpendicular injection technique without pinch-up of a skin fold was recommended for most people with diabetes.…”

Section: Needle Length and Gaugementioning

confidence: 99%

See 1 more Smart Citation

Needle Technology for Insulin Administration: A Century of Innovation

Heinemann¹,

Nguyen²,

Bailey

et al. 2021

J Diabetes Sci Technol

View full text Add to dashboard Cite

Innovations in syringe and pen needle (PN) technology over the last 100 years have led to important advances in insulin delivery for people with diabetes, paralleling the strides made in developing recombinant DNA human insulin and insulin analogs with varying onset and duration of action. In this review, the history of advances in insulin delivery is described, focusing on progress in syringe, needle, and PN technologies. The early glass and metal syringes that required sterilization by boiling have been replaced by disposable, single-use syringes or pens with clear labeling for precise insulin dosing. The early needles ranging in length from 19 to 26 mm that required manual sharpening against a whetstone have been replaced by syringe needles of 6 mm and PNs of 4 mm in length as slender as 34 gauge. Imaging studies using ultrasound and computed tomography measured the thickness of skin and subcutaneous tissue layers to show feasibility of targeted insulin administration with shorter needles. These developments, coupled with innovations in needle/PN wall and tip structure, have led to improved injection experience for people with diabetes. It is also important to acknowledge the role of injection technique education, together with these advances in injection technology, for improving clinical outcomes and patient satisfaction. With continued projected growth of diabetes prevalence, particularly in developing countries where expensive and complex insulin delivery systems may not be practical, insulin syringes and pens will continue to serve as reliable and cost-effective means of insulin delivery for people with diabetes.

show abstract

Section: History Of Innovations In Needle Technologymentioning

confidence: 99%

Section: Needle Length and Gaugementioning

confidence: 99%

Needle Technology for Insulin Administration: A Century of Innovation

Heinemann¹,

Nguyen²,

Bailey

et al. 2021

J Diabetes Sci Technol

View full text Add to dashboard Cite

show abstract

“…Secondly, poor insulin injection techniques might lead to insulin leakage and suboptimal delivery of the insulin dose, and this might affect the level of glycemic control. Hence, researchers have been trying to improve insulin injection techniques for years [14].…”

Section: Introductionmentioning

confidence: 99%

Evaluating the User Preference and Level of Insulin Self-Administration Adherence in Young Patients With Type 1 Diabetes: Experience With Two Insulin Pen Needle Lengths

Hayek¹,

Dawish²

2020

Cureus

View full text Add to dashboard Cite

Background Selecting the appropriate insulin pen needle is important to reduce pain and injection-related adverse events like insulin leakage. It also helps to improve medication adherence and glycemic control in patients with type 1 diabetes mellitus (T1DM). Objective This study aimed to compare the 6-mm and 8-mm 32.5-gauge insulin pen needles in terms of glycemic control, pain score, user preference, medication adherence, and injection adverse events in patients with T1DM. Methods We conducted a prospective cohort study of 62 patients with T1DM. All patients constituted an experimental group initially and then changed the length of the needle to be part of a selfcontrol group. The glycemic control, visual analog scale (VAS) pain score, Morisky Medication Adherence Scale (MMAS) score, needle attribute score, and injection-related adverse events were measured for all patients with both lengths of needles. Patients were assessed at the baseline visit and followed up for three months. Statistical comparisons were done by the chisquared test, paired t-test, and paired Wilcoxon test when appropriate with a two-tailed alpha level below 0.05 indicating statistical significance. Results With the NanoPass® 32.5-gauge, 6-mm needle (Terumo Corp., Tokyo, Japan), patients had significantly lower glycated hemoglobin (HbA1c) compared to 8-mm needles (7.9% vs. 8.3%; p<0.001). The proportions of patients who reported no hypoglycemic episodes were 22/62 and 9/62, with the 6-mm and 8-mm needles, respectively. The 6-mm needles were better in terms of the following parameters compared to 8-mm needles: mean needle attribute scores (36.7 vs. 24.2; p<0.001), median VAS pain scores (20 vs. 55; p<0.001), insulin leakage (6/62 vs. 20/62; p=0.002), and the MMAS score (4.9 vs. 3.4; p<0.001). Conclusion 1 1

show abstract

“…Improvement in insulin pen technology may impact quality of life in the majority of diabetes patients not using insulin pumps, including pediatric patients [14]. The next-A c c e p t e d M a n u s c r i p t generation pens by improving dose accuracy with fine dosing increments will likely make diabetes management more effective [15].…”

mentioning

confidence: 99%