The State of Insulin Injection

Insulin

| Sep 11, 2011

What's Being Researched Now

Oral Insulin-With the demise of Pfizer Inc.'s inhaled insulin, Exubera, the next holy grail for insulin delivery is oral insulin. The biggest problem in developing oral insulin is finding a way to protect the delicate insulin proteins from destruction by digestive system acids.

One current research approach is MonoSolRx Inc.'s edible film, which can be stuck on the inside of a patient's cheek. The insulin-impregnated film dissolves, passing insulin directly into the circulatory system. The New Jersey-based company says that its film has worked well in monkeys and plans to begin human trials later this year in Europe.

Emisphere Technologies, also based in New Jersey, signed a deal with Novo Nordisk in late 2010 to develop an oral insulin. Neither company has stated how long it expects development to take. Another company, Entrega in Boston, is working on several orally taken drugs, including insulin.

Nanotechnology-Medical researchers at the University of California, San Francisco, are working on developing a "nano-box," a tiny protective container with insulin-producing beta cells inside. Microscopic holes in the box are big enough to allow the cells to launch insulin into the bloodstream, but small enough to block entry by the body's autoimmune system agents. (For a video peek at the work being done on this by UCSF Professor of Bioengineering Tejal Desai, go to http://www.youtube.com/watch?v=rY_siujVJEg.)

Long-term Insulin-Insulin injections for type 2s could drop to three per week, according to a study in the British medical journal The Lancet. The study shows that type 2s who received once-daily or thrice-weekly injections of degludec, a long-acting insulin, maintained blood levels similar to those of patients receiving daily doses of insulin glargine.

In the United States, about one in every three type 2 patients injects insulin at least once daily. One problem that healthcare providers run into when treating type 2s with insulin is getting them to adhere to an injection schedule that requires daily injections.

Degludec is being developed by Novo Nordisk. If approved for US sale, it would allow users to go 40 hours between injections-from 14 to 22 hours longer than they can with current long-acting basal insulins. The drug also can be mixed with other insulins. Novo is hoping to reach market by 2013.

Jet Injection-Although recent research shows that jet injection of insulin can work twice as fast as pens in lowering glucose, the technology remains cumbersome and requires a high level of patient commitment. So far, it has not been widely accepted in the marketplace. If smaller, easier-to-use devices can be developed, jet injection's quicker and needle-less delivery could dramatically change consumer perceptions.


New on the Market

Smaller, Cost-saving Pen Needle Batches-UltiMed, which offers the only pen needles assembled in the United States, has announced that it is now providing a 50-count universal-fit pen needle.

Traditionally, pen needles are sold in batches of 100. After Walmart began selling private-label pen needles in 50-count boxes, however, UltiMed decided to enter the market with a matching offer.

The company says that as co-pays rise for many diabetes patients, the ability to buy pen needles in smaller quantities could help them financially. The 50-count product also opens the market to other suppliers and retailers who may want to follow Walmart's lead.

Trends

Insulin Pens-Although up to 90 percent of people with diabetes in some European countries use insulin pens, US market penetration hovers around 20 percent. The higher cost of the pens compared to the traditional vial-and-syringe delivery system is the most often cited reason for low acceptance. In their favor, however, pens help users achieve better compliance and less waste of insulin because the doses are premeasured.

 

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Categories: jet injection of insulin, British Medical Journal The Lancet, Degludec, Diabetes, Diabetes, Exubera, Inhaled Insulin, insulin glargine, Insulin Pens, insulin proteins, long-acting insulin, Novo Nordisk, oral insulin, Pfizer, San Francisco, Type 2 Diabetes, Type 2 Issues, University of California


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Comments

Posted by Anonymous on 16 September 2011

Interesting article.I was shocked to hear only 20 percent of americans use the "insulin pen". I am in thet 20 percent. I use BOTH pen and regular needle. My pen is for my long lasting insulin and the regular syringe is for my fast acting insulin.I must add that useing the pen is far more convient and the needle is actually smaller! The dose is pre measured and the pen delievery system is easy! Id much rather use the pen in BOTH my insulins, but sadly it is only avaiable for my 24 hour insulin.I am quite suprised more people don't use the "pen" delivery system! I love my pen! I think ALL insulins should be avaiable for delerivy via pen system! The pen system is wonderful! It has far less injection site pain then the traditional syringe method!!more people should give the pen a try! I think they would be plesantly suprised on how much they like it! :)

Posted by chanson3633 on 16 September 2011

I would be interested to know if these new delivery methods are "faster" than the traditional injections. In other words, do they get the insulin into the bloodstream more quickly or less quickly? This is the crucial issue for any improvement in the delivery system.

I also resent the off-hand comment that health care providers have trouble getting patients to adhere to injection schedules. I have seen no studies on this, and I have yet to meet a diabetic who fails to take his or her insulin because it is inconvenient or painful.

Posted by Anonymous on 17 September 2011

To the commenrt above about using a syringe and a pen. To my knowledge, all mealtime insulins are now available in pen form as well. You should check on-line or ask your doctor. Did anyone else find it weird that DH blatantly put an ad in the article for Ulticare pen needles? I'm not sure how changing the size of the box of needles is equivalent to all of the other cool things mentioned in the article. Plus my friend let me try one of his Ulticare needles and it actually hurt! I gave him some of mine next time I saw him and he threw away the ones he had. When he went to the pharmacy they ended up being the same price.
My question is, enough with the needle talk- where is the cure?

Posted by Anonymous on 4 October 2011

One company the article did not mention is Oramed Pharmaceuticals. The company is planning on beginning Phase II trials in early 2012 on its oral insulin capsule and has had promising preliminary results.


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