Comparison of NovoPen 3 and syringes/vials in the acceptance of insulin therapy in NIDDM patients with secondary failure to oral hypoglycaemic agents

Kadiri, A.; Chraibi, A.; Marouan, F.; Ababou, M. R.; Guermai, N El; Wadjinny, A; Kerfati, A; Douiri, M; Bensouda, J; Belkhadir, Jamal; Arvanitis, Y

doi:10.1016/s0168-8227(98)00055-2

Cited by 90 publications

(44 citation statements)

References 6 publications

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“…[16][17][18][19] The present study showed a patient preference for bolus-patch over pen/syringe without a difference in glycemic control indices. The pen offers the convenience of having a prefilled insulin delivery device but still requires multiple daily injections and does not offer the ease of use and discreetness of the wearable bolus-patch.…”

Section: Discussionmentioning

confidence: 48%

Comparison of a Novel Insulin Bolus-Patch with Pen/Syringe Injection to Deliver Mealtime Insulin for Efficacy, Preference, and Quality of Life in Adults with Diabetes: A Randomized, Crossover, Multicenter Study

Bohannon¹,

Bergenstal

Cuddihy

et al. 2011

Diabetes Technology & Therapeutics

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Objective: This study compared the efficacy, safety, device satisfaction, and quality of life (QOL) in people with diabetes using an insulin bolus-patch versus current devices (pen/syringe) to deliver mealtime insulin. Research Design and Methods: Thirty-eight subjects with diabetes (26 with type 1 and 12 with type 2) were randomized to bolus-patch or current injection device (55% pen and 45% syringe) to deliver mealtime insulin in a multicenter, 6-week crossover study. Efficacy was assessed by equivalence in mean daily seven-point blood glucose (MDBG). Safety assessments included severe hypoglycemia episodes, adverse device effects (ADEs), and adverse events (AEs). Device satisfaction was determined by the validated Insulin Delivery System Rating Questionnaire (IDSRQ) and QOL by the validated Diabetes Specific QOL Scale (DSQOLS). Results: Using bolus-patch, MDBG (mean -SE) was equivalent to that using pen/syringe (8.61 -0.28 vs. 9.02 -0.26 mmol/L; P = 0.098). SD of the seven-point blood glucose measurements was lower using bolus-patch (3.18 -0.18 vs. 3.63 -0.17 mmol/L; P = 0.004), as was the coefficient of variation (CV) (37.2 -1.7 vs. 40.3 -1.7%; P = 0.046). Hemoglobin A1c, 1,5-anhydroglucitol, fructosamine, and insulin use were similar between groups. There were no severe hypoglycemia episodes or serious ADEs. Between-device AEs were comparable. Subjects scored better on six of seven subscales on the DSQOLS and five of six subscales on the IDSRQ while using boluspatch versus pen/syringe. At study completion, 76% of subjects would choose to switch to bolus-patch (P = 0.001). Conclusions: Delivery of mealtime insulin with bolus-patch compared with pen/syringe resulted in equivalent MDBG, lower SD and CV of seven-point blood glucose measurements, good safety, significant device satisfaction, and improved QOL.

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Section: Discussionmentioning

confidence: 48%

Comparison of a Novel Insulin Bolus-Patch with Pen/Syringe Injection to Deliver Mealtime Insulin for Efficacy, Preference, and Quality of Life in Adults with Diabetes: A Randomized, Crossover, Multicenter Study

Bohannon¹,

Bergenstal

Cuddihy

et al. 2011

Diabetes Technology & Therapeutics

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“…A recent study found that pain perception was significantly less when using an insulin pen device (NovoPen 3, Novo Nordisk) than conventional syringes and vials. 31 The simplicity of insulin pen devices facilitates not only good glycaemic control, but also contributes to improved quality of life. 32 The development of finer, shorter needles has also helped to alleviate the pain of injections.…”

Section: Addressing Risk For Cardiovascular Diseasementioning

confidence: 99%

When oral agents fail: practical barriers to starting insulin

2002

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Insulin therapy has proven benefits in Type 2 diabetes patients when combination therapy has failed. However, there is some reluctance by both patients and healthcare professionals to initiate insulin therapy. This reluctance has been termed 'psychological insulin resistance'. Barriers to the initiation of insulin therapy include patients' fear of disease progression and needle anxiety; mutual concerns about hypoglycaemia and weight gain; and health professionals' use of insulin as a threat to encourage compliance with earlier therapies. It is essential that these obstacles are identified and investigated as a means of overcoming these impediments to recommended levels of glycaemic control, an initiative being pursued by the DAWN study. Where concerns are tangible, such as fear of hypoglycaemia, therapeutic solutions can be pursued. Overcoming psychological barriers relies more on innovative management techniques. Improving insulin delivery to meet these needs, coupled with enhanced healthcare services, can address psychological insulin resistance and contribute to the maintenance of good metabolic control.

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“…Coscelli et al 20 applied an author-developed questionnaire, reporting that 88% of patients considered the pen faster to use, 86% rated it as easier for dose measurement, 55% claimed less pain and 90% preferred it for long-term management, after 6 weeks of treatment. Kadiri et al 21 evaluated the treatment acceptability in 78 patients using a nonvalidated survey. After 12 weeks of usage, he reported that 62.8% of the pen device group considered it easier to use, compared with 32.6% in the VaS group; 89.5% of patients assured they would prefer pen devices for insulin application.…”

Section: Preferencementioning

confidence: 99%

Pen Devices for Insulin Self-Administration Compared With Needle and Vial

Lasalvia

Barahona-Correa

Romero-Alvernia

et al. 2016

J Diabetes Sci Technol

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Objectives: Pen devices offer advantages compared with vial and syringe (VaS). The purpose of this article was to evaluate efficacy of pen devices compared to VaS. Methods: A systematic review of literature was performed in 8 different databases. References were independently screened and selected. Primary observational or experimental studies comparing pen devices with VaS for insulin administrations were included. Studies on specific populations were excluded. Risk of bias was evaluated using appropriate tools. Data on glycosylated hemoglobin (HbA1c), hypoglycemia, adherence, persistence, patient preference, and quality of life (QOL) were collected. Meta-analysis was performed when appropriate. Heterogeneity and risk of publication bias were evaluated. Otherwise, descriptive analyses of the available data was done. Results: In all, 10 348 articles were screened. A total of 17 studies were finally selected: 7 experimental and 10 analytical. The populations of the included articles were mainly composed of adults with type 2 diabetes mellitus. Important risk of bias was found in all of the articles, particularly experimental studies. Meta-analyses were performed for HbA1c, hypoglycemia, adherence and persistence. Pen device showed better results in mean HbA1c change, patients with hypoglycemia, adherence and persistence compared to VaS. No difference was observed in number of patients achieving <7% HbA1c. Preference studies showed a tendency favoring pen devices, however nonvalidated tools were used. One QoL study showed improvements in some subscales of SF-36. Conclusions: There is evidence that pen devices offer benefits in clinical and, less clearly, patient-reported outcomes compared to VaS for insulin administration. However, these results should be taken with caution.

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Comparison of NovoPen 3 and syringes/vials in the acceptance of insulin therapy in NIDDM patients with secondary failure to oral hypoglycaemic agents

Cited by 90 publications

References 6 publications

Comparison of a Novel Insulin Bolus-Patch with Pen/Syringe Injection to Deliver Mealtime Insulin for Efficacy, Preference, and Quality of Life in Adults with Diabetes: A Randomized, Crossover, Multicenter Study

Comparison of a Novel Insulin Bolus-Patch with Pen/Syringe Injection to Deliver Mealtime Insulin for Efficacy, Preference, and Quality of Life in Adults with Diabetes: A Randomized, Crossover, Multicenter Study

When oral agents fail: practical barriers to starting insulin

Pen Devices for Insulin Self-Administration Compared With Needle and Vial

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