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. 2018 Feb;9(1):297-307.
doi: 10.1007/s13300-017-0365-1. Epub 2018 Jan 11.

Patient Perceptions and Preferences for a Mealtime Insulin Delivery Patch

Mark Peyrot  1 , Darlene Dreon  2 , Vivien Zraick  2 , Brett Cross  2 , Meng H Tan  3
Affiliations

Patient Perceptions and Preferences for a Mealtime Insulin Delivery Patch

Mark Peyrot et al. Diabetes Ther. 2018 Feb.

Abstract

Introduction: A basal-bolus insulin regimen is needed to achieve glycated hemoglobin A1c (HbA1c) below 7.0% in people with type 1 (T1D) or type 2 (T2D) diabetes who have significant loss of beta-cell function. Nonadherence to therapy is common and negatively affects the ability to reach treatment goals. We examined patient assessment of a new, wearable mealtime insulin-delivery system (patch) relative to their current mealtime insulin-delivery system (syringe, pen, or pump). The patch is designed to deliver only boluses of fast-acting insulin (no basal insulin), mechanically controlled by the patient.

Methods: Adults (n = 101) with T1D or T2D assessed their current mealtime insulin-delivery system and then assessed simulated (no active medication) patch use over a 3-day period. Participants evaluated mealtime insulin-delivery systems using eight measures from five domains (convenience, interference with daily activities, diabetes-related worry, psychological well-being, and overall satisfaction/preference) on the self-administered Insulin Delivery System Rating Questionnaire. User ratings of their current insulin-delivery systems (syringe, pen, pump) were compared with those for the patch by repeated measure analysis of variance and one-sample t tests.

Results: Participants had significant (p < 0.05) preference for patch over syringe in all eight comparisons, and over pen in five out of eight comparisons, with no significant preference for pen. Although there was a preference for patch over pump in six out of eight comparisons, only one showed a significant preference for patch, and one for pump. Significantly more participants reported that they would like to switch to the patch than continue using a syringe (78% vs 22%) or pen (76% vs 24%) but this difference was not significant for the group using a pump (52% vs 48%).

Conclusions: Participants preferred using the patch over pens and syringes. Its ease of use and discreet method of insulin delivery may contribute to improved patient adherence to mealtime insulin regimens among people currently using injection devices.

Funding: Calibra Medical.

Keywords: Diabetes mellitus; Insulin delivery; Patient preference; Quality of life.

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Figures

Fig. 1
Fig. 1
The wearable on-demand mealtime insulin-delivery system (patch). a The mealtime insulin-delivery patch (Calibra Medical, Inc., Wayne, PA, USA) can be worn for up to 3 days. Mealtime insulin can be dosed discreetly b through clothing by actuating the buttons on both sides of the patch, c which measures no more than 65 × 35 × 8 mm
Fig. 2
Fig. 2
Schematic of the patch. The mechanically timed sequence ensures that the reservoir feature is never directly connected to the user. Sequence: (1) Both the pump and valve button are “out”. (2) Pressing the valve button disconnects the insulin reservoir and opens the pathway to the cannula. (3) Consequently, the pump button depresses, delivering a 2-unit dose. (4) When releasing the buttons, the valve button first returns into the “out” position, closing the pathway to the cannula and reconnecting the insulin reservoir. (5) Finally, the pump button releases and simultaneously draws the next dose from the insulin reservoir. This sequence is repeated for each subsequent dosing
See this image and copyright information in PMC

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