Six models of a new type of insulin pen (MADI) were developed comprising models for insulin U‐40, U‐80 and U‐100 with a single dose of either one or two units of insulin in each of them1−4. Every model may be easily adapted to be used either as a ‘needle pen’ or a ‘catheter pen’. In the needle pen, a sliding cover prevents the contamination of the needle. A syringe‐like interchangeable plastic reservoir (3ml) is filled (and can be refilled up to 100 times) by the patient from the insulin vials, with any kind of soluble insulin. Actual insulin administration occurs by twisting the cap. A clinical trial with 365 adult patients and 46 children (1991‐93) showed good patient satisfaction in 95%. There were 17 MADI pen failures requiring technical assistance in the 12 months of the clinical trial. The preference for a catheter pen was assessed separately in a group of 35 carefully‐trained patients. There was a marginal preference for the needle pen (54% of the patient days) compared with the catheter pen (46% of the patient days). In 345 patients without special training, the catheter pen was only preferred by one patient (0.3%). MADI pen may be recommended as an insulin delivery device of choice. In particular, patients on any form of animal insulin and/or U‐40 and/or U‐80 insulin may benefit from this pen.
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