Improved Insulin Absorption by Means of Standardized Injection Site Modulation Results in a Safer and More Efficient Prandial Insulin TreatmentA Review of the Existing Clinical Data

Abstract

Temperature changes on the surface of the skin lead to modifications of subcutaneous microcirculation. This phenomenon is employed in a standardized way by the InsuPad device to stabilize skin conditions before injections, which is associated with enhanced prandial insulin absorption. Three programmed warming cycles to 40°C within 50 minutes are resulting in faster insulin appearance in the plasma. Early standardized meal tolerance studies indicated a substantial improvement in postprandial glucose control when the same short-acting insulin analog dose was applied using InsuPad, and a dose reduction by 20% resulted in comparable glucose excursions. Similar results were obtained when patients applied the device under real-world conditions for 1 month. The InsuPad device was also tested in a prospective, controlled, parallel 3-month real-world study with 145 well-controlled but insulin-resistant patients with type 1 or type 2 diabetes. Patients were treated to target in both treatment arms (6.2 ± 0.5% in each group), with or without the device. However, patients with InsuPad needed 28% less prandial insulin, needed 12.5% less total insulin, and had 46% less confirmed hypoglycemic events (blood glucose < 63 mg/dL) as compared to the control group. Except for very few inflammatory or allergic skin reactions, there were no device-specific adverse events reported from these studies. In conclusion, use of InsuPad when applying prandial insulin doses may result in a safer and more efficient treatment of type 1 or type 2 diabetes.

Nursing a patient with latent autoimmune diabetes in adults with insulin-related lipodystrophy, allergy, and exogenous insulin autoimmune syndrome: A case report

“…Although some studies have reported lipodystrophy after insulin allergy[ 10 ], the increasing number of different human insulin analogues has led to a significant reduction in the incidence of adverse reactions (0.2%-3.6%)[ 11 ]. After the occurrence of such adverse reactions, the most commonly used countermeasures are changing the type of insulin preparation, changing the administration method, and changing the injection site[ 12 ]. Attempts to desensitize the patient with an insulin pump failed in an external hospital.…”

Insulin Protects Hepatic Lipotoxicity by Regulating ER Stress through the PI3K/Akt/p53 Involved Pathway Independently of Autophagy Inhibition

“…In the patients with NAFLD or HFD-induced animals, the circulating fasting insulin is commonly elevated due to the insulin resistance [ 33 ]. Moreover, insulin injection is a clinically-approved, effectual and widely received way to regulate blood glucose in diabetes and/or NAFLD patients [ 34 , 35 ]. Therefore, we are anxious to know whether increased insulin sensitizes SFA-induced hepatotoxicity via the negative regulation of autophagy and further aggravates the pathological procedure of NAFLD.…”

Towards a Physiological Prandial Insulin Profile: Enhancement of Subcutaneously Injected Prandial Insulin Using Local Warming Devices

“…The use of InsuPad with delayed prandial insulin administration showed an earlier rise in glucose level. However, it resulted in a lower mean maximum glucose excursion (129 vs 142 mg/dL) and lower AUC for postprandial glucose excursion over the 5-h study (54 vs 70 mg/dL) [ 45 , 46 ].…”