Comparison of Inpatient Glycemic Control with Insulin Vials versus Insulin Pens in General Medicine Patients

Horne, J.Fletcher; Bond, Rucha; Sarangarm, Preeyaporn

doi:10.1310/hpj5006-514

Cited by 10 publications

(1 citation statement)

References 21 publications

(28 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[10] However, the superior efficacy of insulin pens in maintaining glycemic control in patients with diabetes has been questioned in several studies. [11, 12]…”

Section: Introductionmentioning

confidence: 99%

Insulin pen use and diabetes treatment goals: A study from Iran STEPS 2016 survey

et al. 2019

View full text Add to dashboard Cite

Background Frequency of insulin pen use, despite its higher costs, is increasing to substitute the traditional use of insulin vials. This study aims to report insulin pen use frequency and its associated factors among participants of the STEPS survey 2016 in Iran, which was conducted based on the World Health Organization (WHO) STEPS methodology. Methods In this cross-sectional study, 19,503 (mean age of 46.03±0.13) out of 30,541 participants of the Iran STEPS survey were included (Inclusion criteria: aged >25 years old and availability of their demographic, clinical, and laboratory results for serum glucose, HbA1c, and lipid profile). Clinical and demographic characteristics, a frequency of use of each diabetes mellitus treatment type, and the association of insulin pen use with health outcomes are reported using descriptive analysis and propensity score modeling. Results There were 1,999(10.85%) individuals diagnosed with diabetes in the population, while 1,160(56.87%) cases were taking antihyperglycemic treatments. In this subset, 240(21.14%) individuals administered insulin with or without using oral agents at the same time. 52.28% of participants who were under insulin therapy used insulin pens. None of the socioeconomic determinants, including gender (p-value = 0.11), type of residential areas (p-value = 0.52), years of schooling (p-value = 0.27), wealth index (p-value = 0.19), marital status (p-value = 0.37), and insurance types (p-value = 0.72) were significantly different among groups using insulin pens and insulin vials. Moreover, in the propensity score modeling, pen usage was not associated with a lower heart attack and ischemic stroke histories, systolic blood pressure, serum lipid profile, blood glucose, or HbA1c levels. Conclusion Results showed that the use of the higher-costing insulin pens compared to traditional vials and syringes is not associated with improved glycemic control and better lipid profile in our sample. Future studies are needed to confirm these findings and to compare other aspects of insulin pen use, including adherence to treatment and cost-effectiveness.

show abstract

“…[10] However, the superior efficacy of insulin pens in maintaining glycemic control in patients with diabetes has been questioned in several studies. [11, 12]…”

Section: Introductionmentioning

confidence: 99%

Insulin pen use and diabetes treatment goals: A study from Iran STEPS 2016 survey

et al. 2019

View full text Add to dashboard Cite

show abstract

Review of Medication Error Sources Associated With Inpatient Subcutaneous Insulin: Recommendations for Safe and Cost-Effective Dispensing Practices

et al. 2022

View full text Add to dashboard Cite

Background: The challenge of addressing variation in practice is underlined by variation in institutional operational and financial limitations, which ultimately directs institutional insulin dispensing strategy. Insulin therapy is multi-modal, and inpatient pharmacies may be responsible for simultaneously managing up to 8 formulations. While available as a tool for glycemic management in the inpatient setting, intravenous (IV) insulin and insulin pumps are out of scope for this review. Considerations when designing subcutaneous insulin dispensing processes include medication safety, infection control, pharmacy workflow, nursing workflow, drug cost, hardware cost, and hospital policy. Objective: This review provides an overview of common inpatient subcutaneous insulin dispensing practices, describes the regulations directing current practice, and discusses the benefits and risks of each dispensing practice. Finally, the review provides recommendations for subcutaneous insulin dispensing practices with respect to institutional limitations that minimize patient safety risk and consider the variable costs that practices incur. Methods: Common formulations will be presented along with medication safety considerations and potential medication administration errors to preface strategies for management. Conclusion: Nearing the centennial anniversary of the invention of insulin, the practice of dispensing subcutaneous insulin products has remained a core responsibility of the hospital pharmacy as a primary treatment option for Diabetes Mellitus. Despite the continued presence of this product as a universal component of the hospital formulary, subcutaneous insulin dispensing practices remain varied institution-to-institution.

show abstract

Centenary of Insulin Therapy: A Review

Kumar

Zargar

Kumar

et al. 2024

CDR

View full text Add to dashboard Cite

Insulin is an endocrine hormone produced by the beta cells of islets of Langerhans in the pancreas. It regulates blood sugar levels and various anabolic activities such as glycogenesis and lipid synthesis. Despite the fact that insulin therapy has been around for 100 years, insulin formulations are continually being improved to lower the risk of hypoglycaemia and other adverse effects, including weight gain. The development of insulin pens has significantly reduced the consequences of hypoglycaemia instead of vials and syringes. Both injectable devices were well-received by the patients. In the population under study, the efficacy and safety profiles of the pen appeared to be comparable to those of the vial/syringe. However, more patients reported that they would like to keep using pen devices. This article aimed to summarize the background of insulin, its mechanism, types, needle size, injection technique, adverse drug reactions and various studies related to insulin. It has been recommended intensive treatment of type-1 and type-2 diabetes patients to achieve good metabolic control and avoid chronic complications caused by poor glycaemic control. Healthcare professionals should address concerns about safe and effective implementation of inpatient hypoglycaemic control and insulin usage and they should empower patients to self-manage their diabetes, so they may improve their quality of life as well as avoid potential complications. Much more progress is expected in the future, at a faster pace, based on the implementation of well-organized recovery efforts, advancing technologies, and scientific collaboration.

show abstract

Comparison of Inpatient Glycemic Control with Insulin Vials versus Insulin Pens in General Medicine Patients

Cited by 10 publications

References 21 publications

Insulin pen use and diabetes treatment goals: A study from Iran STEPS 2016 survey

Insulin pen use and diabetes treatment goals: A study from Iran STEPS 2016 survey

Review of Medication Error Sources Associated With Inpatient Subcutaneous Insulin: Recommendations for Safe and Cost-Effective Dispensing Practices

Centenary of Insulin Therapy: A Review

Contact Info

Product

Resources

About