Connected Insulin Pens and Caps: An Expert’s Recommendation from the Area of Diabetes of the Spanish Endocrinology and Nutrition Society (SEEN)

Abstract

Undoubtedly, technological advances have revolutionised diabetes management in recent years. The development of advanced closed hybrid loop insulin pumps or continuous glucose monitoring (CGM) systems, among others, have increased the quality of life and improved glycaemic control of people with diabetes. However, only some patients have access to such technology, and only some want to use it. CGM has become much more widespread, but in terms of insulin delivery, most people with type 1 diabetes (T1D) and almost all people with type 2 diabetes (T2D) on insulin therapy are treated with multiple-dose insulin injections (MDI) rather than an insulin pump. For these patients, using connected insulin pens or caps has shown benefits in reducing missed insulin injections and promoting correct administration over time. In addition, using these devices improves the quality of life and user satisfaction. The integration of insulin injection and CGM data facilitates both users and the healthcare team to analyse glucose control and implement appropriate therapeutic changes, reducing therapeutic inertia. This expert’s recommendation reviews the characteristics of the devices marketed or in the process of being marketed and their available scientific evidence. Finally, it suggests the profile of users and professionals who would benefit most, the barriers to its generalisation and the changes in the care model that implementing these devices can bring with it.

Nocturnal Glucose Profile according to Timing of Dinner Rapid Insulin and Basal and Rapid Insulin Type: An Insulclock® Connected Insulin Cap-Based Real-World Study

“…Results regarding insulin injection timing and type impact on glycemic control should be confirmed and quantified in real-life settings combining CGM data and automatically tracked insulin dose and time information. Connected insulin pens and caps provide an opportunity to assemble this information and provide a more accurate picture of nocturnal glucose levels [10]. The real-world nature and the methodology (CGM and connected insulin pen data) used in this study are its main strengths.…”

“…There is limited scientific evidence on the nocturnal glucose profile depending on the timing and type of pre-dinner rapid insulin injections. However, connected insulin pens and caps can now automatically track continuous glucose monitoring (CGM) data, as well as the dose and exact time of insulin injections [10]. This is a promising development, as it can help people with T1D to manage their blood sugar levels more effectively and ultimately reduce their risk of complications [11].…”

Diabetes technology: A primer for clinicians

“…These devices are most useful for patients who struggle with dose calculations or who miss or forget doses and may benefi t from missed-dose alerts. 24,25 These options also might be preferable for patients who are less comfortable with technology.…”