Alternative Devices For Taking Insulin

An insulin vial with a needle

Alternative Devices For Taking Insulin

( — Many people who take insulin to manage their diabetes
inject the insulin with a needle and syringe that delivers insulin just under
the skin. Several other devices for taking insulin are available, and new
approaches are under development. For more information about insulin, see
Medicines for People with Diabetes.

Injection aids are devices that help users give injections with needles and
syringes through the use of spring-loaded syringe holders or stabilizing guides.
Many of these aids use push-button systems to administer the injection.

Insulin pens can be helpful if you want the convenience of carrying insulin
with you in a discreet way. An insulin pen looks like a pen with a cartridge.
Some of these devices use replaceable cartridges of insulin; other pen models
are totally disposable. A short, fine needle, similar to the needle on an
insulin syringe, is on the tip of the pen. Users turn a dial to select the
desired dose of insulin and press a plunger on the end to deliver the insulin
just under the skin.

Insulin jet injectors send a fine spray of insulin through the skin by a
high-pressure air mechanism instead of needles.

Subcutaneous infusion sets, also called insulin infusers, provide an
alternative to injections. A catheter (a flexible hollow tube) is inserted into
the tissue just beneath the skin and remains in place for several days. Insulin
is then injected into the infuser instead of through the skin.

External insulin pumps are devices that deliver insulin through narrow,
flexible plastic tubing that ends with a needle inserted just under the skin
near the abdomen. The insulin pump is about the size of a deck of cards, weighs
about 3 ounces, and can be worn on a belt or carried in a pocket. Users set the
pump to give a steady trickle or “basal” amount of insulin continuously
throughout the day. Pumps release “bolus” doses of insulin (several units at a
time) at meals and at times when blood glucose is too high based on the
programming set entered by the user. They also can be programmed to release
smaller amounts of insulin throughout the day. Frequent blood glucose monitoring
is essential to determine insulin dosages and to ensure that insulin is

Approaches Under Development

Implantable insulin pumps are surgically implanted under the skin of the
abdomen. The pump delivers small amounts of insulin throughout the day and extra
amounts before meals or snacks. Users can control doses with a remote control
unit that prompts the pump to give the specified amount of insulin. The pump is
refilled with insulin every 2 to 3 months.

The insulin patch, placed on the skin, provides a continuous low dose of
insulin. Because it’s difficult to overcome the skin’s barriers, delivery of
insulin through the skin is aided with sound waves or an electrical current.

Insulin pills provide insulin in tablet form. Researchers are working on ways
to get the insulin into the bloodstream before it is changed by normal digestive

Researchers are investigating delivering insulin as a spray. A buccal spray
delivers liquid insulin into the mouth. Insulin is then absorbed through the
tongue, throat, and inside of the cheeks. An intranasal spray delivers insulin
as a nose spray.

An artificial pancreas, a surgically implanted device, imitates the action of
the pancreas by sensing blood glucose levels and secreting insulin in response.
The user also can release insulin using a remote control.


Additional Information on Alternative Devices for
Taking Insulin

The National Diabetes Information Clearinghouse collects resource information
on diabetes for the National Institute of Diabetes and Digestive and Kidney
Diseases (NIDDK) Reference Collection. This database provides titles, abstracts,
and availability information for health information and health education
resources. The NIDDK Reference Collection is a service of the National
Institutes of Health.

To provide you with the most up-to-date resources, information specialists at
the clearinghouse created an automatic search of the NIDDK Reference Collection.
To obtain this information, you may view the results of the automatic search on
Alternative Devices for Taking Insulin.

If you wish to perform your own search of the database, you may access and
search the NIDDK Reference Collection database online.




National Diabetes Information Clearinghouse
1 Information Way
MD 20892–3560
Phone: 1–800–860–8747
Fax: 703–738–4929
Email: [email protected]

The National Diabetes Information Clearinghouse (NDIC) is a service of the
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The
NIDDK is part of the National Institutes of Health of the U.S. Department of
Health and Human Services. Established in 1978, the Clearinghouse provides
information about diabetes to people with diabetes and to their families, health
care professionals, and the public. The NDIC answers inquiries, develops and
distributes publications, and works closely with professional and patient
organizations and Government agencies to coordinate resources about diabetes.

Publications produced by the Clearinghouse are carefully reviewed by both
NIDDK scientists and outside experts.

This publication is not copyrighted. The Clearinghouse encourages users of
this publication to duplicate and distribute as many copies as desired.


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The Diabetes Epidemic Among African Americans

A diabetic woman testing her blood glucose level

• Diabetes is a group of diseases
marked by high levels of blood glucose resulting from defects in insulin
production, insulin action, or both. Diabetes can lead to serious complications
and premature death, but people with diabetes can take steps to control the
disease and lower the risk of complications.

• Diabetes is one of the leading causes of death and disability in the
United States. Total health care and
related costs for the treatment of
diabetes run about $132 billion annually.

• Type 1 diabetes (formerly
called juvenile diabetes) results when the body’s immune system attacks and
destroys its own insulin-producing beta cells in the pancreas. People with type
1 diabetes must have insulin delivered by injection or a pump. Symptoms of type
1 diabetes – increased thirst and urination, constant hunger, weight loss,
blurred vision, and extreme fatigue – usually develop over a short period of
time. If type 1 diabetes is not diagnosed and treated, a person can lapse into a
life-threatening coma. Type 1 diabetes accounts for 5% to 10% of all diagnosed
cases of diabetes.

• Type 2 diabetes (formerly called adult-onset diabetes) occurs when the
body does not make enough insulin or cannot use the insulin it makes
effectively. This form of diabetes usually develops in adults over the age of 40
but is becoming more prevalent in younger age groups including children and
adolescents. The symptoms of type 2 diabetes – feeling tired or ill, unusual
thirst, frequent urination especially at night, weight loss, blurred vision,
frequent infections, and slow-healing wounds – may develop gradually and may not
be as noticeable as in type 1 diabetes. Some people have no symptoms.Type 2
diabetes accounts for about 90% to 95% of all diagnosed cases of diabetes. The
following factors increase a person’s chances of having type 2 diabetes: a
family history of diabetes, being a member of an ethnic group such as African
Americans, being overweight or obese, having had diabetes while pregnant
(gestational diabetes), having high blood pressure, having abnormal cholesterol
(lipid) levels, and not getting enough physical activity.

• Gestational diabetes develops during pregnancy. Women who have had
gestational diabetes have a 20 to 50 percent chance of developing diabetes,
mostly type 2, in the next 5 – 10 years.

• 3.2 million African
Americans ages 20 years and older (or 13.3 percent) have diabetes, one-third of
whom are undiagnosed.
• On average, African Americans are 1.8 times more
likely to have diabetes as non-Hispanic whites of similar age.


Cardiovascular disease is the leading cause of death for people with diabetes —
accounting for about 65 percent of all deaths.
• People with diabetes are 2
to 4 times more likely to have heart disease or suffer a stroke than people
without diabetes.
• People with type 2 diabetes have the same high risk for
heart attack as people without diabetes who already have had a heart
• About 73 percent of people with diabetes also have high blood
• Smoking doubles the risk for heart disease in people with

• Diabetes is a self-managed disease.
People with diabetes must take responsibility for their day-to-day care.

The chances of having diabetes complications can be reduced or delayed
significantly by keeping blood glucose (blood sugar), blood pressure, and
cholesterol levels (called the ABCs of Diabetes) in the target range. The
National Diabetes Education Program (NDEP) recommends the following targets for
reducing risk of heart disease and stroke for people with diabetes:

A1C (Blood Glucose)
Less than 7 percent
(check at least twice a
Blood Pressure
Less than 130/80 mmHg
(check every doctor’s
Cholesterol (LDL)
Less than 100 mg/dl
(check once a year)

• People with diabetes can manage their disease by eating healthy foods,
being physically active, taking diabetes medicine as prescribed, and testing
blood glucose levels.
• Community education and support programs can help
people with diabetes and their families to manage their diabetes.

• YES! The Diabetes Prevention Program (DPP), an important trial
sponsored by the National Institutes of Health, showed that type 2 diabetes can
be delayed or prevented in overweight adults with prediabetes, including African
Americans. Pre-diabetes is a condition where blood glucose levels are higher
than normal, but not yet high enough for a diagnosis of diabetes.
• Risk
factors for pre-diabetes are the same as those listed for type 2 diabetes.

To prevent diabetes, the people who participated in the DPP study:
Lost 5 to
7 percent of their body weight (that’s 10 to 15 pounds in a person who weighs
200 pounds).
Were physically active for 30 minutes a day, 5 days a week. Most
participants chose brisk walking.
Made healthier food choices and limited the
amount of calories and fat in their diet.

For more information about preventing and controlling diabetes, call
1-800-438-5383 or visit the National Diabetes Education Program’s website at
from National Institute of Diabetes and Digestive and Kidney Diseases. National
Diabetes Statistics fact sheet: general information and national estimates on
diabetes in the United States, 2005. Bethesda, MD: U.S.
Department of Health
and Human Services, National Institute of Health, 2005.