Insulin delivery by injection in children and adolescents with diabetes

Hanås, Ragnar; Beaufort, Carine de; Hoey, Hilary; Anderson, Barbara J.

doi:10.1111/j.1399-5448.2010.00731.x

Cited by 23 publications

(24 citation statements)

References 66 publications

(64 reference statements)

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“…The majority of participants were receptive to starting insulin despite being upset, disappointed, shocked and anxious. The health professionals were highly experienced at initiating insulin and used insulin pens with high associated patient acceptance and quality of life [33] , [34] . Other interventions to overcome PIR included encouraging engagement with self-monitored blood glucose results, prescribing a low starting dose of insulin, supervising initial injections, and having patients inject themselves [32] .…”

Section: Discussionmentioning

confidence: 99%

Treating psychological insulin resistance in type 2 diabetes

Allen

Zagarins

Feinberg

et al. 2017

Journal of Clinical & Translational Endocrinology

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Section: Discussionmentioning

confidence: 99%

Treating psychological insulin resistance in type 2 diabetes

Allen

Zagarins

Feinberg

et al. 2017

Journal of Clinical & Translational Endocrinology

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“…Injecting insulin with a syringe or pen is the insulin delivery method used by most people with diabetes (1,2), with the remainder using insulin pumps or automated insulin delivery devices (see sections on those topics below). For patients with diabetes who use insulin, insulin syringes and pens are both able to deliver insulin safely and effectively for the achievement of glycemic targets.…”

mentioning

confidence: 99%

7. Diabetes Technology: Standards of Medical Care in Diabetes—2019

2018

Diabetes Care

165

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The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC. Diabetes technology is the term used to describe the hardware, devices, and software that people with diabetes use to help manage blood glucose levels, stave off diabetes complications, reduce the burden of living with diabetes, and improve quality of life. Historically, diabetes technology has been divided into two main categories: insulin administered by syringe, pen, or pump, and blood glucose monitoring as assessed by meter or continuous glucose monitor. More recently, diabetes technology has expanded to include hybrid devices that both monitor glucose and deliver insulin, some automatically, as well as software that serves as a medical device, providing diabetes self-management support. Diabetes technology, when applied appropriately, can improve the lives and health of people with diabetes; however, the complexity and rapid change of the diabetes technology landscape can also be a barrier to patient and provider implementation. To provide some additional clarity in the diabetes technology space, the American Diabetes Association is, for the first time, adding a dedicated section on diabetes technology to the "Standards of Medical Care in Diabetes." For this first writing, the section will focus on insulin delivery and glucose monitoring with the most common devices currently in use. In future years, this section will be expanded to include software as a medical device, privacy, cost, technology-enabled diabetes education and support, telemedicine, and other issues that providers and patients encounter with the use of technology in modern diabetes care. INSULIN DELIVERY Insulin Syringes and Pens Recommendations 7.1 For people with diabetes who require insulin, insulin syringes or insulin pens may be used for insulin delivery with consideration of patient preference, insulin type and dosing regimen, cost, and self-management capabilities. B 7.2 Insulin pens or insulin injection aids may be considered for patients with dexterity issues or vision impairment to facilitate the administration of accurate insulin doses. C

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“… 5 - 7 Modifications to design aspects of injection devices that diminish these challenges can help to ease the burden of treatment. The predominant injection options are vial and syringe, insulin pens, and insulin pumps, 3 , 8 - 10 utilization of which varies by geographic region. 11 Both pumps and pens have distinct advantages compared with vial and syringe, 8 , 9 but not all pediatric patients are candidates for pumps.…”

mentioning

confidence: 99%

“…The predominant injection options are vial and syringe, insulin pens, and insulin pumps, 3 , 8 - 10 utilization of which varies by geographic region. 11 Both pumps and pens have distinct advantages compared with vial and syringe, 8 , 9 but not all pediatric patients are candidates for pumps. 12 - 14 Greater accuracy 15 - 17 and preference for pen devices versus vial and syringe with respect to ease of use, convenience, and discreetness 17 - 19 have been shown with better efficacy and safety outcomes, 20 - 22 better adherence, 20 , 22 , 23 and less pain.…”

mentioning

confidence: 99%

Dose Accuracy, Injection Force, and Usability Assessment of a New Half-Unit, Prefilled Insulin Pen

Kappes

Kershner

Morwick

et al. 2017

J Diabetes Sci Technol

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Background:This study examines the utility of the first prefilled, rapid-acting insulin pen that can be dialed in half-unit increments. Dose accuracy and injection force were examined through a series of design-verification tests, and usability was established by human factors validation testing.Methods:Devices were tested for dose accuracy at 3 different doses and temperatures and under free fall, vibration, and cold storage conditioning. Injection force was measured at the maximum dose (30 units). Both experiments used the same semiautomated testing system. Usability was validated in a human factors simulated-use study that included 60 participants (patients with type 1 or type 2 diabetes [aged 10-79 years], adult caregivers, and health care providers).Results:The pen met the International Organization for Standardization (ISO) 11608-1:2014 requirements for dose accuracy at all settings and conditions tested. Furthermore, all individual results were within the ISO specification limits. Mean injection force across temperature settings ranged from 9.25 to 10.85 N at the highest dose. The usability validation study confirmed that use-related risks were reduced to the extent possible and that additional modifications were not likely to afford further reductions.Conclusions:The results from these studies demonstrated accurate dosing over the dose range (0.5-30 units) at different temperatures and conditions with an injection force that should accommodate the intended users. Use safety and usability in patients with diabetes, caregivers, and health care professionals were validated. The added convenience of this new half-unit, prefilled pen may ease the burden of diabetes management for patients who require smaller incremental dosing.

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Insulin delivery by injection in children and adolescents with diabetes

Cited by 23 publications

References 66 publications

Treating psychological insulin resistance in type 2 diabetes

Treating psychological insulin resistance in type 2 diabetes

7. Diabetes Technology: Standards of Medical Care in Diabetes—2019

Dose Accuracy, Injection Force, and Usability Assessment of a New Half-Unit, Prefilled Insulin Pen

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