Diabetes Care: Exploring Needle-Free Insulin Delivery in the UK
Time to read 9 min
Time to read 9 min
Gone are the days when you need to inject yourself with painful syringes and needles several times a day.
Advancements in diabetes care have given us needle-free insulin delivery systems, a pain and anxiety-free method of taking insulin.
This article will explore the game-changing potential of needle-free insulin delivery and how these methods can make your diabetes care easier.
Insulin delivery is how an insulin dose reaches the bloodstream to regulate blood sugar levels.
It doesn't matter how you take your insulin therapy, whether through insulin injections, an insulin pump, nasal spray, or a conventional insulin pen.
These methods are considered insulin delivery devices, and each has pros, cons, and absorption rates.
When your healthcare provider puts together your diabetes care plan, they consider which insulin administration method is best for your case. They also consider your personal preferences, convenience, and any special requirements.
For example, type 2 diabetics who suffer from Parkinson's disease might have a hard time holding a syringe, so doctors might prescribe an insulin pump instead.
Other diabetics might have a needle phobia, which makes needle-free insulin therapy, such as insulin jet injectors, a better choice.
Insulin is one of the most vital hormones in your body, whether you have diabetes or not. It regulates your blood sugar levels throughout the day, especially at mealtimes when your blood sugar spikes from food.
Insulin takes the excess blood glucose and pushes it into your body cells to be burned for energy. This is important because having high blood glucose levels can lead to organ damage and complications such as heart disease, stroke, kidney failure, and blindness.
Insulin delivery is all about getting the right amount of insulin your body needs at the best absorption rate and time.
For example, if you're about to have a carb-rich meal, take short or rapid-acting insulin a few minutes beforehand. You also need to ensure your insulin delivery method allows for quick absorption so the insulin can reach your bloodstream quickly and start working.
Insulin jet injectors, for example, have fast absorption rates and provide early postprandial glucose control. This means they don't allow your blood sugar to spike too much with food.
These devices can be the key to controlling plasma glucose levels and keeping your diabetes in check.
Despite being the oldest and most common method of insulin administration, traditional syringes have several limitations and drawbacks.
One significant challenge is the risk of injection site reactions, which can cause pain, redness, swelling, and itching at the injection site. This discomfort can lead to anxiety and stress, making it difficult for patients to adhere to their prescribed treatment regimen.
You can minimize injection site reactions by regularly rotating your injection sites between thighs, arms, and abdomen, but it’s still a hassle. A needle-free insulin injector, on the other hand, doesn’t cause irritation because it lacks a needle.
Another issue with traditional insulin therapy is the inconvenience and embarrassment associated with frequent injections. Not only do you have to draw insulin from a vial repeatedly, but you also need to ensure you have your insulin treatment with you at all times.
People with diabetes, especially type 1, often must inject themselves multiple times daily, which can be awkward and uncomfortable, especially in public settings.
An insulin jet injector or insulin pump can be much more discreet than a syringe, allowing you to take your insulin dose in seconds.
Insulin pens can get the job done, but they have limited doses, and you might run out of insulin, unlike some jet injectors, which can be reused up to 5,000 times.
You must constantly rotate your injection site with traditional needles to avoid skin irritation. In addition to being inconvenient, this also results in poor glycemic control because different body parts have different insulin absorption rates.
These fluctuations can lead to sporadic blood sugar levels, which makes it difficult to control your diabetes.
Diabetes UK warns people with less body fat (small body mass index) against injecting insulin into their upper arms since there’s a high chance of being injected into muscle tissue rather than subcutaneous tissue.
Muscle tissue has a much faster absorption rate, and injecting short-acting insulin, such as regular human insulin, might cause hypoglycemia (low blood sugar).
This is unlikely with other devices, such as insulin jet injectors, because they’re designed to only reach the subcutaneous layer and no further.
There are several types of needle-free injection devices, each with unique advantages and disadvantages.
Here are a few needle-free delivery systems your healthcare provider might consider.
Needle-free jet injectors are arguably the best and most popular delivery system for people who dislike needles.
They provide an easy method of taking your insulin injections without the pain, skin irritation, and technical difficulty of traditional syringes.
While some diabetics think jet injectors are complicated, they’re actually quite easier to use than syringes or other devices.
Most jet injectors are composed of three main parts:
Jet injectors rely on a compressed spring or gas cartridge instead of using a needle to penetrate the skin and deliver your insulin dose. The spring-loaded mechanism is much more common because it’s lightweight, inexpensive, and more efficient.
When the spring mechanism is loaded, it pushes your insulin dose out at a very high speed, under high pressure, in the form of a fine jet steam. This jet stream is so fine because of the high pressure it enters your skin through the pores rather than penetrating it as a needle would.
The insulin jet stream travels through your skin layers until it reaches the subcutaneous layer and disperses.
The insulin dose doesn’t just stay in one spot until absorption, unlike with traditional syringes.
Instead, the insulin is distributed and dispersed in a small subcutaneous tissue area, leading to better, more uniform absorption.
For example, a 2017 study was carried out where type 2 diabetics were split into two groups, and a randomized clinical trial was carried out. The first group used an insulin pen, while the other used an insulin jet injector.
The patients used regular human insulin and rapid-acting insulin. The idea was to see how the different delivery systems would affect patients' blood glucose and insulin levels.
Ultimately, the trial proved that the insulin jet injectors group had better control over their insulin and blood glucose levels.
In a few cases, the jet injectors worked too well, and the blood glucose level dropped a bit, but this was quickly reversed when the patients ate.
An earlier 2013 study also showed similar results. Patients who used an insulin jet injector had fewer spikes in their sugar levels following meals compared to insulin pens.
InsuJet is an example of an insulin jet injector that revolutionized the concept of needle-free injection.
It improved on the basic idea of a jet injector by incorporating the following features:
Insulin inhalers are a needle-free method of delivering insulin directly into the lungs, quickly absorbing it into the bloodstream.
These devices use a dry powder formulation of insulin that is inhaled through a mouthpiece, much like an asthma inhaler.
The concept of inhaled insulin has existed since the 1990s, and the first FDA-approved inhaler came out in 2006. However, it didn’t catch on with diabetics, and a year later, it was taken off the market.
In 2014, Afrezza, another FDA-approved insulin inhaler, was approved for diabetes but only before meals to control mealtime blood glucose.
Today, most insulin inhalers contain either rapid or short-acting insulin, and there aren’t any long-acting formulations of inhaled insulin.
This means diabetics taking inhaled insulin still need to take intermediate or long-acting insulin injections to control their blood sugar throughout the day.
Transdermal insulin patches are another needle-free insulin delivery method. Much like a nicotine patch, you stick it onto your skin, and the insulin passes through your skin layers to be absorbed.
Insulin patches usually have a set number of doses and must be replaced regularly when the doses are finished.
Some patches are designed to release bolus insulin doses at mealtimes, while others provide a steady release of insulin day and night.
The former are called bolus insulin patches, while the latter are called basal insulin patches. Transdermal patches are currently in development as scientists are working on making the insulin molecules smaller so they can pass through the skin.
The era of needles and syringes may soon be behind us.
As needle-free insulin delivery becomes more accessible, more diabetics are switching to these easier, pain-free alternatives.
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