The Barmer study: impact of standardized warming of the injection site to enhance insulin absorption and reduce prandial insulin requirements and hypoglycemia in obese patients with diabetes mellitus

Abstract

When treating obese patients to target with insulin therapy, use of an injection-site warming device for 3 months resulted in a lower frequency of hypoglycemic events and a reduction in prandial insulin analog requirements. If these results are confirmed in other patient populations, an injection-site warming device may be useful in achieving treatment targets with a safer and more efficient basal bolus therapy in insulin-treated patients with type 1 and type 2 diabetes.

Standardized modulation of the injection site allows for insulin dose reduction without deterioration of metabolic control

“…All other patients participated in both meal tolerance test procedures. The patients in this sub-study presented with similar characteristics to the patients in the underlying larger real-world study and showed comparable results after 3 months of therapy 11 . They were on intensive insulin treatment only without using additional oral antidiabetic medication.…”

“…The prospective real-world Barmer study was conducted from May 2012 to February 2013 with 145 patients 11 . A total of 32 patients were randomized and analyzed for this meal tolerance test sub-study.…”

“…To reach this very good control, the device group needed 20% less prandial insulin and a low hypoglycemic event rate. In contrast, the control group needed 8% more insulin and had twice as many hypoglycemic events, significantly more than the modulation device users 11 .…”

“…to analyze the key observation parameters for the patients in the MTT subgroup as described previously 11 . The additional meal tolerance test results were analyzed in a descriptive way and interpreted in an exploratory manner.…”

New Insulins and New Aspects in Insulin Delivery

“…In 2004, an oral spray was reported to lower glucose levels when used as a prandial insulin (84). Similarly, in 2004, another company reported proof of concept results for glucose lowering with another oral insulin preparation (85,86).…”