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The following is an informal, unscientific review of some of the leading injection aid products on the market. It is not the result of a comprehensive consumer satisfaction survey. While we are thankful for the responses from our readers included in the article, it should be noted that they are the opinions solely of the individuals and do not reflect the views of Diabetes Health.
To help alleviate the daily burden of insulin injections, medical companies have developed two main varieties of injection aids; insulin pens and syringe aids. Both help the user inject with a regular syringe and make injections less time-consuming, easier to give and more comfortable. They can also be quite helpful for injecting in hard-to-reach places. Some deliver the needle and insulin simultaneously, while others require the user to push a syringe plunger after the automatic injection of the needle.
Recognizing that injection aids vary in size and performance, Diabetes Health decided to review some of the different injection aids on the market. We would like to thank our electronic readers for their assistance on this project. We posted a question to our internet readers on our e-mail newsletter asking them to review the injection aids they have used. Their responses are included throughout the article.
Owen Mumford has two insertion aids on the market, Autoject and Autoject 2. The Autoject delivers the needle and insulin simultaneously. The device is approximately 8" long, but when the spring-loaded catch is engaged a 3" knob must be extended. It is made of durable plastic, and the company recommends the product for children. The aid comes in a handy blue carrying case about the size of a pencil holder with four color-coded needle depth adjusters. The suggested retail price is $35, and Owen Mumford can be reached at (800) 421-6936.
"I have used the Owen Mumford Autoject for well over 10 years," writes e-mail subscriber Tom Maloney of Rock Island, Ill. "It is, for me, a very good aid. I like the way it works and how it is loaded and cocked. Sometimes when out in public I will even fire it through my shirt. There has never been a problem using it. I tried to get another one to keep in my travel case so that I would always have one. Instead I was sent the Autoject 2 by Owen Mumford. Although this device is also easy to use I was not as happy with it. I ended up sending the Autoject 2 back when it jammed and it was replaced with an Autoject. The Autoject is such a help in the management of my diabetes. I take three to five injections a day."
Owen Mumford calls their Autoject 2, "the self-injection made simpler." More discreet in color and procedure than Autoject, Autoject 2 also automatically delivers the insulin when the needle is inserted. New features of the Autoject 2 include: a safety lock to prevent accidental discharge of the loaded syringe, an observation window, easy-to-read injection depth adjusters and a depth guide to ensure proper and consistent injection depth.
The Autoject 2 is made of durable plastic and is also about 8" long. The white and light blue aid is a one-handed, one-touch, automatic injector making it convenient for children and people with arthritis to use.
The Autoject 2 comes in two models; the AJ 1300 and the AJ 1311. The AJ 1300 can be used with B-D (0.5 cc, 1 cc and 2 cc), Terumo (0.25 cc, 0.5 cc and 1 cc) and Braun (0.5 cc and 1 cc) fixed needle syringes. The AJ 1311 is for use with the B-D 1 cc non-fixed needle syringes. The Autoject 2 has a suggested retail price of $40. For more information call (800) 421-6936.
Cam McIntosh of West Allis, Wis., writes, "I've been using the Autoject 2 for over a year and a half and love it. Since I found the Autoject 2 my shots rarely hurt. The shots are easier to take and, best of all, no more hiding in the bathroom to take them! No one sees the needle once it is inside, so I am able to shoot in public without anyone being disturbed ... I couldn't live without my Autoject 2. This device helped me experience a huge improvement in my blood sugars. I can now take my insulin on the run, since I don't have to be as steady-handed with the device. I know this sounds like a commercial, but it is true!"
Instaject, by Jordan Medical Enterprises, is a combination injector and lancet device. This "painless automatic injector" is pocket size and looks like a plastic spark plug. It is a self-contained injector that does not require any adapters, fits any brand of syringe and has a built-in adjustable needle depth function. The aid is easily transformed into a lancet module, fitting most brands of lancets including Monolet, Trends, Autoclix, Autolancet, Surelet and EZ-Let. Pushing the two buttons on either side of the device allows the insulin needle, or lancet, to be delivered into the skin.
The product comes with a one-year guarantee. Contact Jordan Medical at (800) 541-1193 for more information.
Palco Labs' Inject-Ease injection aid is compatible with most disposable insulin syringes and allows for adjustable needle depth. The directions that come with the product are easy to understand and the product masks the sensation of injections.
When Inject-Ease (about the size of a cigar) is pressed against the skin and rotated a few times it produces a mild sensation that masks the feeling of needle penetration. The procedure is a two-step process; the thumb presses the trigger and the index finger pushes the plunger of the syringe.
The product comes with a five-year guarantee and has a suggested retail price of $32.50. For more information contact Palco Labs at (800) 346-4488.
David Thomas of Key West, Fla., writes, "I use the Inject-Ease 50, and it works great for me. By twisting the end of the unit against my skin, I don't even feel the tiny stick. I have always been terrified of needles, so not seeing the needle has helped me a great deal. I have used the Inject-Ease 50 for over three years, two to three injections a day, and have never had a problem with it. I highly recommend it."
Lee Boylan of San Jose, Calif., writes, "I usually use the Palco Inject-Ease with my long-lasting insulin, Lente and Ultralente. Most of the time, it causes no injection sensation. In fact, the first time I used it I thought something was wrong as I felt nothing at all. I heartily recommend it for parents to use with children, if they use syringes."
Made of steel, the MonojectÂ¨ Injectomatic fits in the palm of your hand. This syringe injector can be used with Monoject's and store-brand Ultra-ComfortÂª insulin syringes (1 cc, 1/2 cc and 3/10 cc). When the spring loaded syringe is pressed against the injection site the needle is automatically inserted, but the needle depth cannot be adjusted. The unit sells for $20 to $25. For more information, contact Can-Am Care at (800) 461-7448.
"We have people who have been using (Injectomatic) ten to 15 years," says Gaby Boucher, marketing representative at Can-Am Care.
Diana Kilby of San Antonio, Texas, writes, "I have used the Monoject Injectomatic for many, many years. I use it for places that I cannot reach and find it works great."
Subcutaneous Infusion Set
InsuflonÂ¨, a multiple injection therapy aid distributed by Chronimed Inc., reduces the frequency of needle injections. To use Insuflon, a single needle, covered by a tiny flexible catheter, is placed in the fatty tissue of the abdomen. The needle is then pulled out and an adhesive strip is placed over the catheter to hold it securely in place. This catheter can remain in place for seven days. Insulin is then injected through the Insuflon resealing tube, rather than through the skin.
The device can be used with all insulins and works well with insulin pens and syringes.
The suggested retail price for a box of 10 is $49.95. Chronimed can be reached at (800) 888-5957.
The American Diabetes Association suggests that the risk of local infection is higher with this device. They recommend paying even more attention to sterile technique than with the usual syringe and needle method.
Of the injection aids on the market, insulin pens have become especially popular because of their convenience. They are about the same size as an ink pen, making them easy to carry and store. Perhaps their most attractive feature is that they eliminate the need to carry around bottles of insulin. Cartridges in the body of the pen contain units of insulin, so the user only needs to carry the pen. By turning a dial on the pen, the user can determine how many units are delivered at each injection.
As Lee Boylan of San Jose, Calif. writes, "Insulin pens eliminate the need to invert a vial and draw into a syringe, and thus are much more discreet. The needle only goes into you and never through a stopper. That results in more comfort. The needles are small and usually cause no sting at all."
They are also especially helpful for multiple dose schedules. Once the injector is set for the number of units an individual needs, the pen automatically delivers the set dosage when triggered.
NovoPen 1.5, by Novo Nordisk, is an inconspicuous "dial-a-dose insulin delivery device." It comes in a gray plastic carrying case and is available in a variety of colors. It takes three steps to activate the pen; dial the dose, insert the needle, and push the button. As a safety measure, the directions recommend the user to conduct a function check once a month or before starting a new box of PenFill cartridges. The function check is done by delivering 20 units of insulin into the outer needle cap, not into the body. The Pen is used with NovolinÂ¨ PenFill cartridges and NovoFineÂ¨ disposable needles only. The needles and cartridges are not sold with the Pen and must be purchased separately. The average wholesale price of the NovoPen is $39. For more information contact Novo Nordisk at (800) 727-6500.
According to the number of responses we have received on the NovoPen, it seems to be the most highly regarded, although Bruce Beale of London, UK, a Pen user for about 20 years, has one small complaint. He writes, "Sadly, animal insulin is not available in the cartridges and wickedly I have to reuse old cartridges by refilling them with animal insulin. This has never caused me any problems and is probably a good deal more hygienic than the way we used to have to use mother's nail file, carborundum stones and spit in the 1940s to sharpen our needles."
Adell Carr Smith of Battlefield, Mo. adds, "I have a NovoPen and I love it. However, I have not been able to use it since August. Before that, I used it when my sliding scale of insulin injections did not require half units (as the Pen doesn't give doses in 1/2-unit increments). Since August I've been on Humalog, and there are no cartridges for my NovoPen. So there sits my lovely NovoPen and needles with no place to go."
"NovoPen is small, convenient and allows me to inject my insulin (with the dosage in one-unit increments) wherever I am and whenever I need to. As far as I know, the other pens on the market only allow you to adjust your dosage in two-unit increments, which is very inconvenient when you use a sliding scale for your insulin ..., " writes Megin Agostinelli of Houghton, Mich.
The B-D Pen is a lightweight plastic injection device by Becton Dickinson that is the size of a large marking pen. The Pen can inject up to 30 units of insulin at a time and has a dial that measures out doses from one to 30 units in one-unit increments like the NovoPen. Unlike the NovoPen, the B-D Pen does not require the user to conduct a function check. B-D provides (free of charge to patients who call to request one at (800) 237-4554) a magnifying lens that easily attaches to the pen at the dial site to assist in measuring doses.
It can be used with all 1.5 ml insulin cartridges. B-D suggests the Pen be used with B-D one-use needles; the B-D Ultra-Fine Original Pen Needles (29 gauge 1/2") and B-D Ultra-Fine II short pen needles (30 gauge 5/16"). B-D claims both needles can be used to inject with the NovoPen 1.5, Novolin PrefilledÂª and the NovolinPen insulin delivery systems as well.
The B-D Pen sells for approximately $35 to $45, retail price. For more information, contact Becton Dickinson at (800) 237-4554.
Sandie Francis of Fresno, Calif., has been using the B-D Pen for over a year. In her response, she describes the difference she sees between the NovoPen and the B-D Pen. She writes, "I've been using the B-D Pen for well over a year now, and I really do like it ... I have also tried the NovoPen, and I don't like it nearly as much as the B-D Pen. I find the NovoPen much heavier (it's made of metal, the B-D pens are plastic) and a lot harder to push (to deliver the insulin). They are very nice looking though ..."
Lee Boylan of San Jose, Calif. writes, "For my fast-acting insulin, I use both the NovoPen and B-D Pen. The two are very similar. A Canadian friend gave me the B-D Pen over a year ago. At the time, the only cartridges and needles available in the U.S. were made by Novo Nordisk. They fit perfectly. The NovoPen looks a little snazzier, but the B-D Pen takes less thumb pressure on the end to deliver a dose."
The Autopen by Owen Mumford is a multi-dose insulin injection system. Similar in shape to an ink pen, but slightly thicker, the Autopen is available in two models for use with all 1.5 ml insulin cartridges. The pen comes in a compact case with three pen needles and instructions. A unique feature of the Autopen is its side-mounted activation button which allows for better handling and easy administration of the selected dose.
The AN 3100 model delivers insulin doses in one-unit increments from one to 16 units, and model AN 3000 delivers doses in two-unit increments from two to 32 units. The suggested retail price for both models is $35.50. For more information contact Owen Mumford at (800) 421-6936.
Novolin 70/30 Prefilled
Another option to consider is the Novolin 70/30 Prefilled made by Novo Nordisk. Each package contains five disposable plastic pens that come preloaded with needles and insulin. The prefilled syringe is not recommended for the blind or visually impaired without the assistance of a sighted individual trained in the proper use of this product. For more information contact Novo Nordisk at (800) 727-6500.
Do Your Homework
Before purchasing an injection aid, it is important to consider what features will serve you best. The ideal aid for one person may be inappropriate for another. While some aids offer greater convenience, others offer adapters for the visually impaired and others are more suitable for children. The descriptions of these products, and the reviews provided by our readers, should help you make a more educated decision when choosing an aid. They should only be the first step in the process, however. Further investigation will help you find the product that best suits your needs.