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arrow Buyer's Guide

Insulin Delivery

03 January 2007
Syringes, pumps, jet injectors, pens, infusers, they all do the same thing -- deliver insulin.

These items carry insulin through the outermost layer of skin into fatty tissue so it can be used by the body. This category also includes injection aids--products designed to make giving an injection easier. Most of these products can be purchased from the PDM secretariat


Today's syringes are smaller and have sharper points and special coatings that work to make injecting as easy and painless as possible. When insulin injections are done properly, most people discover they are relatively painless. You should test several brands of syringes to find the one that you like best. Check with your doctor to make sure you buy the equipment that's right for you.

Questions to ask:

1. Does the syringe dose match your insulin strength? If you take U-100 insulin, use U-100 syringes. (Generally, this is not a problem in Malaysia because U-100 is standard here).

2. Is this the right size syringe for your dosage? Some syringes are designed for less than 30 units per injection. If you take 45 units, this syringe would NOT be a good choice for you. However, if you require less than 30 units at any time, a smaller syringe measures these smaller doses more accurately.

3. Can you easily draw up your dosage in this particular syringe? Does the syringe barrel have the kind of markings you can read easily -- or are they too close together? Does having a plunger that's a different colour make it easier for you?

4. Does this brand come packaged as you prefer? Cost is another factor because many stores use insulin syringes as key sale items. Shop around for a good price, but ask yourself: Is giving up a good local pharmacist to save $2 at an out-of-the-way store worth the money?

Reusing disposable syringes is a cost-saving idea. But be sure to discuss the proper procedure with your health care team. And please, always follow appropriate guidelines for disposing of your syringes.

The best way to dispose of your syringe (and your lancets) is to place them in a puncture-proof container that can be sealed shut before it is placed in the garbage.


The insulin pump is not an artificial pancreas because you still have to monitor your blood glucose level. But improved blood sugar control can be achieved, and many people prefer this continuous system of insulin delivery over injections.

Insulin pumps are miniature, computerized pumps, about the size of a call-beeper, that you can wear on your belt or in your pocket. They deliver a steady, measured dose of insulin through a cannula (a flexible plastic tube) with a small needle that is inserted through the skin into the fatty tissue and taped in place.

On your command, the pump releases a bolus (a surge) of insulin; this is usually done about half an hour before eating to blunt the rise in blood glucose after the meal. Because the pump releases incredibly small doses of insulin continuously, this delivery system most closely mimics the body's normal release of insulin. Finding this ideal basal rate for continuous flow plus the appropriate boluses for your body requires time and a great deal of communication between you and a health care team familiar with insulin pumps. Insulin pumps are not for everyone. To use a pump, you must be willing to test your blood glucose at least four times a day and learn how to make adjustments in insulin, food, and exercise in response to those test results.

You also need to understand that an insulin pump will not cure diabetes -- and in fact may even require more work than your previous treatment plan. You'll want to check with your insurance carrier before you buy a pump and all the supplies.

Questions to ask before you buy:

1. Can this pump be programmed to change the basal rate for different times of the day -- or do you have to program each change separately?

2. How does the alarm on this model work and what does it mean when it goes off? How long will this pump battery last and how will you know when it is running low?

3. Ask your doctor: How often should I change the syringe? Many people have chosen the insulin pump because they believe it enables them to enjoy a more flexible lifestyle. But pumps deliver very precise insulin doses for different times of day, which in many instances are necessary to correct the dawn phenomenon, or the rise of blood sugar that occurs in the hours before and after waking.

Before you consider pump therapy, ask yourself: Am I willing to assume this level of responsibility for my diabetes care?You are more likely to spill ketones if there is a blockage or disrupted flow when you are on a pump because you have no depot of long-acting insulin.

The hardware can be awkward at times because you wear it 24 hours a day, and you have to be fastidious about cleanliness, so it's not for everyone. If you are interested, talk to your health care team.

Injection Aids.

This category includes devices that make giving an injection easier as well as syringe alternatives. Talk with your doctor or diabetes educator about these kinds of products.

Often times, they will make sample products available to you before you make a purchase. You'll want to look for an item that is easy for you to use and is durable.

Some items require more skill and dexterity on the part of the user than others, so test several before you buy. This will help you choose the one that is easiest for you to use.

Insertion aids

These devices accelerate needle insertion into the skin. Some even aid in pushing down the plunger. Most are spring-loaded and hide the needle from view.

Syringe alternatives.

At present, this category includes infusers, insulin pens, and jet injectors. Infusers create "portals" into which you inject insulin. With an infuser, a needle is inserted into subcutaneous tissues and remains taped in place, usually on the abdomen, for 48 to 72 hours. The insulin is injected into it, rather than directly through the skin into the fatty tissue. Some people are prone to infections with this type of product, so be sure to discuss the necessary cleaning procedures with your health care team.

Carrying around an insulin pen is like having an old-fashioned cartridge pen in your pocket -- only instead of a writing point, there's a needle, and instead of an ink cartridge, there's an insulin cartridge.

There are even disposable insulin pens now available. The devices are convenient and often used by people on a multi-dose regimen. Insulin cartridges may come in limited total capacities of Regular, NPH, or 70/30 premixed insulin.

They are particularly useful for people whose coordination is impaired, or for people who are on the go. Jet injectors release a tiny jet stream of insulin, which is forced through the skin with pressure, not a puncture.

While there are no needles with these devices, there can be problems with bruising and insulin absorption rates. You will need to work with your health care team to assure good blood glucose control as you adjust to one of these devices.

You'll want to ask manufacturers about training on the use of a jet injector, as well as how to clean it and how to troubleshoot. Be advised that injectors are not cheap, so check to be sure your insurance covers them.

If jet injectors interest you, discuss their use with your health care team.

For people who are visually impaired there are several products designed to make injections easier. Some products handle more than one task.

Non-visual insulin measurement. Help you measure an accurate dose of insulin. Some click at each 2-unit increment of insulin.

Needle guides and vial stabilizers. Help you insert the needle into the correct insulin vial for drawing up an injection.

Syringe Magnifiers enlarge the measure marks on a syringe barrel. It is important to note that certain of these aids fit only with specific brands of syringes, so check to be sure the product you want works with your syringe.

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