People with diabetes need insulin to manage their condition. The way insulin is given is important and involves pens, syringes, pumps, ejectors and inhalers. Vivian Fonseca, MD, professor of medicine at Tulane University School of Medicine, said patients should consider which delivery tool is most comfortable to use, in addition to health insurance. For example, some people are comfortable with a syringe, while others are more comfortable with a pump.
Pros and cons of insulin syringes
An insulin syringe is used to inject insulin into the body with a very fine needle. It has the following advantages:
- Flexible. You can choose from different types of needles and syringes, and you can also inject any kind of insulin with a syringe.
- Low cost.
It has the following disadvantages:
- Cumbersome steps. The real problem with the syringe is some of the fixed steps you have to take. Before you inject, you need to suck the syringe full of air, fit the needle, and then draw the correct dose of insulin into the syringe.
- Easy to make mistakes. The syringe is completely manual, so there is a higher chance of error, and it is entirely up to the patient to determine whether the correct dose of insulin has been injected.
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Advantages and disadvantages of insulin pens
Insulin pens work in much the same way as syringes, but look more like pens used to write. There are two types, disposable and reusable.
Disposable pens come pre-filled with insulin. Reusable insulin pens use a refill that is filled with insulin.
Benefits:
- Simple and easy. The patient simply adjusts the pen to the desired insulin dose and then presses the plunger at one end to inject the insulin through the needle at the other end.
- Memory storage. This memory feature reminds the patient how much insulin was used and when it was used.
Cons:
- Higher cost. Insulin pens are slightly more expensive than syringes.
- Fewer options. Some insulins cannot be injected with an insulin pen.
Pros and cons of insulin pumps
An insulin pump is about the size of an old pager. Patients need to wear it on a belt or carry it in a pocket. The insulin pump delivers a steady stream of insulin to the patient 24 hours a day through a needle attached to a plastic hose. More insulin is injected before each meal by pressing a button on the pump, i.e., a high dose.
The insulin pump is for people with type 1 diabetes who are not achieving their blood glucose control goals with other delivery methods. It is also for people with diabetes who are very physically active.
Benefits:
- Insulin
- Stable insulin release. The insulin pump works by mimicking the way the body secretes insulin – a smaller dose is secreted during the week and the amount is increased during meals.
- Effective and efficient. Less insulin is consumed with an insulin pump than with a syringe or insulin pen.
- Easy to use. No need for multiple injections throughout the day; the insulin pump automatically injects insulin into the body, and patients can also eat at any time.
- Better blood glucose control. The insulin pump provides a steady supply of insulin, so it prevents blood glucose fluctuations from occurring.
- Easy monitoring. The insulin pump can be coupled with a glucose monitoring system so that blood glucose can be monitored and daily activities can be adjusted as needed.
Cons:
- Needs to be worn all the time. The patient has to be connected to the device almost all the time – even when sleeping.
- There is a risk of infection. Needles must be changed every few days, and care needs to be taken when changing needles, as this can lead to infection.
- Glucose monitoring is required. Patients are more likely to experience hypoglycemia than with syringes or insulin pens.
- May malfunction. If the catheter slips out or the pump malfunctions, the patient cannot get the insulin he or she needs. Over time, blood glucose can rise, which can then lead to a serious complication, diabetic ketoacidosis.
- Costly. To the pump itself, add the cost of ever-increasing supplies (such as batteries and sensors). The longer you use it, the more it costs.
Advantages and disadvantages of insulin injectors
This drug delivery device does not have a needle, but uses ultra-high pressure to spray a fine mist of insulin into the body through the pores on the skin.
Advantages:
- No needles are used. If you don’t like the needles of insulin syringes or insulin pens, you can choose the jets.
Cons:
- It hurts. “Surprisingly, in some patients, the injector caused more pain than the needle,” Fonseca noted. Close to the surface of the skin is where the body’s nerves are highly concentrated. Therefore, delivering insulin through the skin can be more painful than an injection.
- Imbalanced insulin delivery. Insulin jets are administered through pores in the skin and therefore do not ensure accurate dosing.
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Advantages and disadvantages of inhaled insulin
The US Food and Drug Administration (FDA) has approved an inhaled rapid-acting insulin for use before meals.
Pros:
- Timing. Peak blood levels are reached about 15 to 20 minutes after administration, and potency fades after 2 to 3 hours.
- No needle. The user places one dose of powdered insulin into a small whistle-sized inhaler. Dose units are cartridges, and each cartridge contains one unit dose.
Cons:
- More insulin is needed. inhaled insulin can be used in both type 1 and type 2 diabetes. However, it should be used in combination with long-acting insulin in people with type 1 diabetes.
- Risks. Patients should not use inhaled insulin if they are smokers or have chronic lung disease. Before starting this insulin, the doctor will give the patient several lung tests.