Delivering your Insulin: A Catalogue of Devices

Individuals who have diabetes may be required to take insulin. There are various methods used to administer insulin today. Technology has improved insulin administration methods over the years to make it easier for you to give yourself a “shot” in the safety and privacy of your own home. It requires a little skill and also knowledge of what to use and where to use it. In other words, you need to know not only what method works best but what injections sites are suitable.

Selection of injection sites

When it comes to injections sites, there are several possible choices. The most common areas chosen for self administration include:

  • Lower abdomen
  • Front of the thighs

If, instead, you have the assistance of a partner or your parent, you may receive the shot in the upper outer buttocks.

In administering insulin, it is best to remember these facts:

  1. The speed of uptake is quickest the closer it is to the center of the body. This is why it is better to inject insulin near the abdomen than in the legs.
  2. The deeper the injection, the more effective or efficient the uptake of insulin.
  3. Exercise also makes the employment of insulin more effective.
  4. Using a fresh site is also beneficial.

If you want to keep your injections comfortable and yet effective, you also need to keep in mind some basic information such as the following:

  • Always be sure to inject in the right spot. If you make a mistake and hit muscle tissue it will cause discomfort and can affect your insulin dosage.
  • Watch the temperature of your insulin. Keep the bottle you currently use at room temperature to reduce the sting. Insulin remains stable at room temperature for about one month. Additional bottles should be stored in the refridgerator.
  • Make sure the area is clean and the alcohol you use has dried before injecting. This will prevent stinging.
  • Be fluid in injection not forceful.[1]

Mechanical Devices – Usage and Types

There are various devices to for giving insulin. There are even some designed to help those with visual or manual disabilities. The following reflect the different types of devices currently available for use in injecting insulin.

  • Needles – The conventional way to administer insulin has been and still is a small syringe and fine needle. Typically this method involves injecting the pre-established quantity in the select spot of the body. The needles are available in different sizes. The finer bore needles hurt less, but are more difficult to inject. The opposite holds true of the larger sized needles. In selecting a needle, remember the large number given a size does not indicate its true size because a large number needle is actually a small bore needle. The opposite is true for large needles. The length of the needle is calculated in a different fashion than bore.

The natural companion of the needle is the vial. It will contain 10 ml (1000 units) of insulin. Generally, people have two vials containing different types of insulin.[2]

  • Pens – Rather than use needles, some prefer to employ pens. These are small, automatic devices that administer a preset dose from a cartridge that is inserted. Numerous types are available under different brand names. Essentially, they come in two types: reusable or disposable. Some prefer these to needles for a variety of reasons. They are considered:
  • More discreet
  • Offer greater convenience in delivering insulin
  • Provide a more accurate dosage (you simply turn a dial to the correct units you want to deliver)
  • Decrease pain due to smaller-gauge needles
  • Provide easier usage for certain populations e.g., older adults, children, adolescents, and pregnant women
  • Are more readily accepted at school or other social gatherings
  • Provide greater flexibility in terms of disposable or reusable options[3]

 

Indwelling devices – This is an under-the-skin needle (subcutaneous cannula) or thin needle that remains in place for several days. This limits the number of injections you can give yourself. While fulfilling several different needs, they have one potential fault – localized skin infections are common.

Jet – Jet injectors do not prick your skin like a needle. These devices blast the insulin through the surface of intact skin. They administer a pre-fixed dose of insulin. These are not yet widely available.

Inhalation – Inhalers provide you with an alternative way to take in insulin. They resemble the devices used by asthmatics. Unfortunately, there has been little interest in using this means of administering insulin. This resulted in its removal from the market. However, recently the Food and Drug Administration (FDA) has been approached again with the intent of marketing this device once more.

Pumps (aka: continuous subcutaneous insulin infusion therapy) – The natural source of insulin lies within the pancreas. This organ pumps insulin into the body. In doing so, it provides both a baseline dosage and a bolus dosage with meals. The development of a mechanical device that mimics these actions is, theoretically, the ideal solution to receiving insulin for diabetics. The design of such a device that responds in a way that is identical to the pancreas is yet to be realized. There are devices used to provide a continuous insulin infusion under the skin. It does so through an implanted pump. The complete device consists of a battery operated pump, a reservoir for the insulin, and a delivery system made up of a needle and of tubing.

This is a safe and very effective means of delivering the required insulin if used properly.[4] There are, however, many potential problems that may interfere with the use of this device. They include the following:

  • Expense – These devices are quite costly with the initial expenditure as well as outlay for maintenance and expendable supplies
  • Failure – This is always a possibility with any form of mechanical reproduction
  • Visibility – They can be seen by others
  • Active involvement – They interfere with leading an active life particular y if you want to be involved in sports
  • Monitoring – these devices require repeated finger stick monitoring

Yet, for many individuals, the positive aspects of this device easily outweigh any of the cons.

Conclusion

When it comes to administering your own insulin, you are currently able to decide what method is best for you. You can base this on suitability and/or convenience. Technology has created a variety of means through which you can control your insulin delivery based on your own initiative. While science and medical technology have not yet devised a machine to mimic completely the actions of the pancreas, it is possible that such a device may be developed in the future. Until then, you should use whatever device delivers the insulin efficiently, effectively and easily.

References

[1] Stanley, K (2009). 50 Things You Need To Know About Diabetes. Alexandria, VA: ADA.

[2] Meltzer, SJ; and Belton, AB (2009). Diabetes in Adults. Toronto: Key Porter Books.

[3] Baruah, MP (2011). “Insulin Pens: The Modern Delivery Devices.” J of the Association of Physicians of India, 59 (April Supplement): 38-40.

[4] Penfornis, A; Personeni, E; and Borot, S (2011). “Evolution of Devices in Diabetes Management.” Diabetes Technology & Therapeutics. 13(S1): S-93 – S102.

This article was originally published July 12, 2012 and last revision and update of it was 9/10/2015.