Diabetes care - insulin delivery in a changing world

Abstract

Controlling blood glucose levels within acceptable limits is crucial to the long-term health of patients with type 2 diabetes, and patient involvement is a vital element in achieving this goal. The benefits of patient education and chronic disease management tools cannot be underestimated as many patients will require initiation of insulin therapy to achieve glycemic targets. The wide choice of insulin formulations and the ever-expanding range of delivery methods now available make insulin administration easier, less painful, more discreet, and more accurate than ever before, thus providing important tools to overcome barriers to insulin initiation and improve achievement of glycemic goals. In addition, exciting developments in technology for self-monitoring of blood glucose have increased the potential for optimal glycemic control. This review discusses how these approaches can help patients manage their diabetes.

Figure 1

Patient preferences in insulin delivery options. Republished from: Korytkowski M, Bell D, Jacobsen C, Suwannasari R; FlexPen Study Team. A multicenter, randomized, open-label, comparative, 2-period crossover trial of preference, efficacy, and safety profiles of a prefilled, disposable pen and conventional vial/syringe for insulin injection in patients with type 1 or 2 diabetes mellitus. Clin Ther. 2003;25:2836-2848. Copyright 2003, with permission from Excerpta Medica, Inc.

Figure 2

Comparison of confidence in patients' ability to use 3 insulin pen devices, as rated by patients and healthcare professionals. This figure was generated from data published in: Lawton B, Berg B. Comparative evaluation of FlexPen, a new prefilled insulin delivery system, among patients and healthcare professionals. Diabetes. 2001;50:A440. (Publisher: American Diabetes Association, US)

Figure 3

Adjusted HbA_1c levels by frequency of self-monitoring in patients with type 1 or type 2 diabetes. Karter AJ, Ackerson IM, Darbinian JA, et al. Self-monitoring of blood glucose levels and glycemic control: the Northern California Kaiser Permanente Diabetes register. Am J Med. 2001;111:1–9. Copyright Elsevier 2001.