Islet Transplantation Eliminates the Need for Insulin Injections

December 15th, 2010

laboartory equipment

Islet cells are sugar-sensing cells in the pancreas that release insulin in order to maintain normal blood sugar levels in the body. In type 1 diabetes, the cells can no longer make insulin because the body's immune system has destroyed them. Type 1 diabetics must take daily insulin injections, usually a complex combination of short and long acting insulin.

Islet cell transplantation involves removing insulin-producing cells from a donor pancreas and transferring them into a person with diabetes. It's a non-surgical procedure in which the donated cells are inserted through a needle directly into the liver. Scientists developed the procedure in the 1960s, but the first islet transplantation attempts didn't take place until the 1990's. To everyone's disappointment, only 8% of the first transplants were successful. The problem was the same faced in other organ or tissue transplants - the recipient's immune system recognized the islets as foreign invaders, and attacked them. Adding to the problem, the anti-rejection drugs in use at the time interfered with insulin's effectiveness.

Canadian researchers at the University of Alberta (U of A) made a major breakthrough in 1999. Using sophisticated islet collection and preparation techniques and improved anti-rejection drugs, they achieved an impressive initial 100% success rate for the first month. But most of their patients eventually had to return to insulin injections as the transplanted islets lost their ability to function, although taking lower doses.

Over ten years later, islet transplantation is still an experimental procedure. Rejection issues remain, and it's difficult to obtain the typically 1 million islet cells needed for one procedure - the equivalent of two pancreases. Islet transplants are currently being performed at 17 research centers across the US, but are not widely available. The procedure is normally restricted to type 1 diabetics between the ages of 18 and 65 who have had diabetes for more than 5 years and have trouble with blood glucose control, resulting in serious complications.

In a successful islet cell transplant, the donor islets make insulin and release it into the patient's bloodstream. They also monitor and stabilize blood sugar levels, eliminating the need for daily insulin injections and frequent blood sugar monitoring. But islet transplant patients must take strong anti-rejection drugs for the rest of their lives, many of which have serious side effects. Unfortunately, most patients need more than one transplant to produce enough insulin that they can stop taking insulin injections. Although islet transplants still fall short of a cure, a successful procedure improves the quality of life of the patient, and lowers the risk of serious long-term diabetes complications such as stroke, heart disease, kidney disease, and eye and nerve damage.

Progress continues to be made towards better anti-rejection drugs, and improved methods to transplant the cells. Researchers are also attempting to obtain donor islets from other sources such as animals, and even trying to grow islet cells in the laboratory. The University of Wisconsin Health Centre claims about 80% of patients receiving an islet transplant have been able to stop taking insulin completely, and that those that still need insulin injections achieved better glucose control. As the procedure is still so new, the longest known period of insulin independence following a US transplant is 4 years. The pioneering U of A program reports that 15-20% of their patients remain insulin independent for 5 years after treatment, and these results are improving.

In the meantime, most Type 1 diabetics will continue to control their condition with diet, exercise, lifestyle changes and a combination of short and long acting insulin, and to follow the developments in islet transplants with great interest.

Insulin Producing Cell Pouch Approaching Clinical Trials in Humans

January 7th, 2011

A Canadian health sciences company focusing on innovative medical technology has successfully tested an organ-like device containing insulin producing islet cells in animals, and is pursuing FDA approval to conduct clinical trials in humans in 2011. There were no adverse side effects associated with the device during the study, during which the diabetic pigs receiving the insulin delivery system achieved long-term blood sugar control.

Sernova Corporation's patented Cell Pouch System is implanted under the skin, where it develops into what the company refers to as "a tissue engineered pancreas" when infused with islet cells. The islet cells deliver insulin to the body, much as the islet cells of the pancreas do in people and animals without insulin dependent diabetes.

Current islet cell transplantation involves removing insulin-producing cells from a donor pancreas and transferring them through a needle directly into the liver of a person with diabetes. The technology is still considered experimental, and is hampered by the body's immune system, which sees the insulin producing cells as foreign invaders and attempts to reject them. The Cell Pouch protects the cells from the immune system, eliminating the need for powerful anti-rejection drugs, which often have serious side effects. The Cell Pouch would be less costly, and requires only about 10% of the insulin producing islets used in the existing islet cell transplant technique.

According to the American Diabetes Association, diabetes is the sixth leading cause of death in the US. The number of American adults diagnosed with diabetes has more than doubled over the past decade, rising from 9 million to 19 million, largely because of soaring obesity rates. While they are more effective, the newer diabetes medications can cost as much as ten times more than the older generic diabetes drugs. Given the option to both save money and avoid daily insulin injections, most diabetics would welcome the option of the new Cell Pouch.

Sernova Corporation says its Cell Pouch System has the potential to treat a wide range of conditions besides insulin dependent diabetes, including Parkinson's disease, spinal cord injury, and hemophilia.

Injection-Free Insulin Inhaler Awaiting FDA Approval

January 24th, 2011

A new injection-free insulin inhaler is awaiting FDA approval for the treatment of both type 1 and type 2 diabetes. Insulin can't be taken orally, as digestive juices break it down before it can be used by the body. Currently, the only means of delivering insulin are subcutaneous insulin injections or intravenously.

AFREZZA is an ultra-rapid acting inhaled insulin developed by MannKind Corporation. It uses patented Technospere technology to deliver powdered insulin from a thumb-sized device into the lungs. The lungs are an effective option for delivering diabetes medication, largely because of their huge surface area (about the size of a single tennis court).

AFREEZA is a short-acting mealtime insulin, meaning type 1 diabetics will need to combine it with long-acting insulin for complete diabetes control. Clinical trial participants using the new insulin inhaler experienced less hypoglycemia and weight gain than did controls using a standard combination of long-acting glargine insulin and twice a day 70 30 insulin injections.

Generex Biotechnology Corporation also has a rapid-acting insulin spray in clinical trials. Oral-lyn is a buccal spray insulin which is absorbed through the buccal mucosa (mucous membranes on the inside of the cheeks), bypassing the lungs and quickly entering the blood stream. The inhaled insulin is sprayed in the mouth just before meals, delivering about one unit of human insulin per spray. If approved, it may be the only medication needed by many type 2 diabetics.

Oral-lyn's patented inhalation device resembles an asthma inhaler. Steven Elkman was an Oral-Lyn study participant who successfully managed his type 2 diabetes with the experimental spray insulin. Elkman loved how discreet the inhaler is. "Nobody really notices because so many people use inhalators for asthmatic medication," he says, "It doesn't really attract any attention."

The FDA actually approved the first inhaled insulin, called Exubera, to treat type 1 and type 2 diabetes in 2006. It was a short-acting powdered form of recombinant human insulin, delivered into the lungs through an insulin inhaler. But the new system of insulin delivery never really caught on, and Pfizer dropped the novel diabetes medication from the market a year later. AFREZZA is easier to use, faster acting and boasts better bioavailability than Exubera, enabling diabetics to achieve better insulin levels using smaller amounts.

Patients in clinical trials of the new inhaled insulins have reported enhanced quality of life, overall satisfaction, and greater acceptance of being insulin dependent. Dr. Larry Deeb, a pediatric endrocrinologist from the University of Florida College of Medicine, says that finding an alternative to insulin injections is crucial, especially for children and the needle-phobic. "Insulin administration is a huge issue for people with diabetes," he stresses, "You have to appreciate the fear [of injections]. Insulin omission is one of the major issues in diabetes."

Injection-Free Insulin Inhaler Awaiting FDA Approval

January 24th, 2011

A new injection-free insulin inhaler is awaiting FDA approval for the treatment of both type 1 and type 2 diabetes. Insulin can't be taken orally, as digestive juices break it down before it can be used by the body. Currently, the only means of delivering insulin are subcutaneous insulin injections or intravenously.

AFREZZA is an ultra-rapid acting inhaled insulin developed by MannKind Corporation. It uses patented Technospere technology to deliver powdered insulin from a thumb-sized device into the lungs. The lungs are an effective option for delivering diabetes medication, largely because of their huge surface area (about the size of a single tennis court).

AFREEZA is a short-acting mealtime insulin, meaning type 1 diabetics will need to combine it with long-acting insulin for complete diabetes control. Clinical trial participants using the new insulin inhaler experienced less hypoglycemia and weight gain than did controls using a standard combination of long-acting glargine insulin and twice a day 70 30 insulin injections.

Generex Biotechnology Corporation also has a rapid-acting insulin spray in clinical trials. Oral-lyn is a buccal spray insulin which is absorbed through the buccal mucosa (mucous membranes on the inside of the cheeks), bypassing the lungs and quickly entering the blood stream. The inhaled insulin is sprayed in the mouth just before meals, delivering about one unit of human insulin per spray. If approved, it may be the only medication needed by many type 2 diabetics.

Oral-lyn's patented inhalation device resembles an asthma inhaler. Steven Elkman was an Oral-Lyn study participant who successfully managed his type 2 diabetes with the experimental spray insulin. Elkman loved how discreet the inhaler is. "Nobody really notices because so many people use inhalators for asthmatic medication," he says, "It doesn't really attract any attention."

The FDA actually approved the first inhaled insulin, called Exubera, to treat type 1 and type 2 diabetes in 2006. It was a short-acting powdered form of recombinant human insulin, delivered into the lungs through an insulin inhaler. But the new system of insulin delivery never really caught on, and Pfizer dropped the novel diabetes medication from the market a year later. AFREZZA is easier to use, faster acting and boasts better bioavailability than Exubera, enabling diabetics to achieve better insulin levels using smaller amounts.

Patients in clinical trials of the new inhaled insulins have reported enhanced quality of life, overall satisfaction, and greater acceptance of being insulin dependent. Dr. Larry Deeb, a pediatric endrocrinologist from the University of Florida College of Medicine, says that finding an alternative to insulin injections is crucial, especially for children and the needle-phobic. "Insulin administration is a huge issue for people with diabetes," he stresses, "You have to appreciate the fear [of injections]. Insulin omission is one of the major issues in diabetes."

Innovative Insulin Delivery Patch-Pen About to Hit the Market

January 24th, 2011

In a recent Loyola University study out of Maryland, 60% of diabetics admitted to occasionally skipping doses of their diabetes medication, 20% admitted to regularly skipping their medication, and one-third of respondents admitting to dreading their insulin injections.

Most diabetics who give themselves insulin injections use traditional syringes or the newer insulin pens. Although insulin pens can be used more discreetly than insulin syringes, insulin dependent diabetics often find it inconvenient and/or embarrassing to inject their insulin in public.

A California company, Calibra Medical, has developed a new insulin delivery system designed to save diabetics the "occasional social challenges" of daily mealtime injections. The new device, Finesse, is a small plastic patch-pen roughly 2 inches long and an inch wide that is attached to the skin like a bandage. It can be worn under your clothes, and remains attached during routine activities like sleeping, exercising and even showering.

Patients use a syringe to pre-fill the patch-pen with a three-day supply of insulin, and simply push two buttons to dispense a dose of fast-acting insulin when needed. The insulin is delivered in seconds through a miniature, flexible plastic tube inserted painlessly into the skin. The device can be operated through your clothing for discreet dosing. The device would not replace the need for long-acting insulin injections.

"Most patients want to eliminate the social embarrassment, elaborate preparation before each dose and the many daily needle sticks required by syringes and insulin pens," says Calibra Medical's Charman and CEO, Jeffery Purvin. "Like expensive insulin pumps, Finesse provides fast, discreet, needle free dosing. Yet it accomplishes this with the simplicity, safety and affordability of syringes or insulin pens."

Finesse recently received FDA approval, and should be on the market soon. Calibra is also working on a patch-pen that would deliver a .05 unit insulin dose for children.

Injection Port Offers an Alternative for Insulin Delivery

February 1st, 2011

pin cushion

While most insulin dependent diabetics grow used to giving themselves multiple injections each day, there are many who would welcome an alternative insulin delivery system. An insulin pump is one such alternative, but some diabetics dismiss them as too expensive, too prone to malfunction, or just too complicated.

A less high tech (and thus less expensive) insulin delivery system is an injection port. An injection port, also called an indwelling catheter, is an FDA approved disposable medical device that is inserted just under the skin, providing a way to administer insulin injections without multiple skin punctures. The device is suitable for both type 1 and type 2 diabetics who take insulin.

An injection port contains a tiny, flexible plastic tube called a cannula, which is inserted into the skin's fatty tissue with one quick, firm push with an "introducer needle" - said to be equivalent to the prick of an insulin syringe. The introducer needle is then removed, leaving the port attached to the skin with an adhesive, and the cannula just under the skin in the fatty tissue. One manufacturer is about to release the i-port Advance, which combines a port with a built-in injector device to eliminate the need for manual insertion.

Once the port is in place, further insulin injections can be delivered with a syringe or an insulin pen directly into the port and through the cannula, eliminating the need to pierce the skin. The port can remain in place for up to 72 hours, and handle up to 75 injections. It can be worn while bathing, swimming and exercising. As the slogan forthe i-Port says, "It takes the shots for you."

Injection ports are popular with diabetics who are new to injecting insulin, those who are needle phobic, and those who are prone to bruising at the injection site. Diabetics struggling with these issues often skip meals to avoid having to take insulin injections, or skip a needed injection to avoid the discomfort or inconvenience. They are also popular with those who have to administer insulin injections to children.

Ports are small and discreet. They are usually worn on the abdomen, but can also be worn places like the arm, thigh or buttocks. One such port, insuflon, is inserted at a 20 to 45 degree angle and worn like an IV, making it ideal for people with little fatty tissue.

Drawbacks include the risk of infection at the insertion site, and the potential for poor medication delivery if the cannula becomes bent or crimped. The manufacturers suggest diabetics test their blood sugar levels two to four hours after each insulin injection to ensure that the device is working properly. The cost of an insulin port is covered by many insurance companies.

Injection Port Offers an Alternative for Insulin Delivery

February 1st, 2011

pin cushion

While most insulin dependent diabetics grow used to giving themselves multiple injections each day, there are many who would welcome an alternative insulin delivery system. An insulin pump is one such alternative, but some diabetics dismiss them as too expensive, too prone to malfunction, or just too complicated.

A less high tech (and thus less expensive) insulin delivery system is an injection port. An injection port, also called an indwelling catheter, is an FDA approved disposable medical device that is inserted just under the skin, providing a way to administer insulin injections without multiple skin punctures. The device is suitable for both type 1 and type 2 diabetics who take insulin.

An injection port contains a tiny, flexible plastic tube called a cannula, which is inserted into the skin's fatty tissue with one quick, firm push with an "introducer needle" - said to be equivalent to the prick of an insulin syringe. The introducer needle is then removed, leaving the port attached to the skin with an adhesive, and the cannula just under the skin in the fatty tissue. One manufacturer is about to release the i-port Advance, which combines a port with a built-in injector device to eliminate the need for manual insertion.

Once the port is in place, further insulin injections can be delivered with a syringe or an insulin pen directly into the port and through the cannula, eliminating the need to pierce the skin. The port can remain in place for up to 72 hours, and handle up to 75 injections. It can be worn while bathing, swimming and exercising. As the slogan forthe i-Port says, "It takes the shots for you."

Injection ports are popular with diabetics who are new to injecting insulin, those who are needle phobic, and those who are prone to bruising at the injection site. Diabetics struggling with these issues often skip meals to avoid having to take insulin injections, or skip a needed injection to avoid the discomfort or inconvenience. They are also popular with those who have to administer insulin injections to children.

Ports are small and discreet. They are usually worn on the abdomen, but can also be worn places like the arm, thigh or buttocks. One such port, insuflon, is inserted at a 20 to 45 degree angle and worn like an IV, making it ideal for people with little fatty tissue.

Drawbacks include the risk of infection at the insertion site, and the potential for poor medication delivery if the cannula becomes bent or crimped. The manufacturers suggest diabetics test their blood sugar levels two to four hours after each insulin injection to ensure that the device is working properly. The cost of an insulin port is covered by many insurance companies.

Why Have Insulin Jet Injectors Never Really Caught On?

February 18th, 2011

An insulin jet injector sounds like a great idea. Intended to be a less painful way of delivering insulin than the traditional insulin syringes or insulin pens, they deliver a fine jet of insulin under such high pressure that it is able to penetrate the skin without a needle.

The first insulin jet injector, dubbed the "peace gun", was invented by a doctor in the 1940s for mass immunization of American troops. It was used right up until 1997, when it's use was discontinued because of concerns around cross-contamination from multiple users. According to all reports, the peace gun was efficient, but painful.

The jet injector was first offered for individual use in 1979. A modern insulin injector looks similar to an insulin pen, but larger. There are a number of different models, but the typical insulin injector consists of three pieces - a metal pen-like delivery device, a disposable plastic nozzle, and a disposable adapter to connect the injector to an insulin vial. The insulin injector has a dosing dial that allows individual users to select their correct dosage.

The metal injector is designed to last for years, and the detachable nozzle and adapter are intended for multiple uses before disposal. The air pressure is created by either a powerful spring device or a nitrogen or cartridge dioxide cartridge. The devices have adjustable pressure settings so users can select the one that is most effective while causing them the least discomfort.

There are some obvious benefits to a needle free jet injection system, the most apparent being the option for the needle phobic to avoid needles. Other advantages are the speed and ease of use, safety (no bent or broken needles, or "sharps" to dispose of ), less risk of contamination, a better spread of insulin into the subcutaneous tissue, no scar tissue build up at the injection site, and no need to keep buying syringes.

So why do so few diabetics use them? The number one reason seems to be pain. Although some people find a needleless injection quite tolerable, many find the pressure required to force the insulin through the skin most uncomfortable. It's not uncommon for the skin at the injection site to bleed, swell and/or bruise.

Another major factor is the initial cost (at least several hundred dollars) although this is offset by the fact that users don't have the ongoing expense of syringes. Not all insurance companies cover the cost of an insulin injector, and many of those that do require a letter from your doctor.

Jet injectors are also more cumbersome and less portable than insulin syringes or insulin pens, not just because they're larger and heavier, but also because users also need to carry an insulin vial (which requires refrigeration), the adapter and, with some models, the nozzle along with it.

It takes more time to set up an insulin injector than it does to fill a syringe. Unlike a syringe or insulin pen, an insulin injector requires maintenance, and has to be taken apart and sterilized on a regular basis. Some people are put off by the noise made by the compression system during use.

There are insulin injectors specially designed for use in children, and even one for dogs and cats, the Zoe Pet Jet. Those who have managed to find a comfortable setting on their jet insulin injector seem quite happy with the devices, and urge new users not to give up if they're not initially comfortable using one.

Animus Issues Urgent Recall Notice to Insulin Pump Users

March 12th, 2011

In a rare development that all insulin dependent diabetics should be aware of, Johnson & Johnson has recalled around 384,000 cartridges for its Animus Insulin Pump.

To date, twenty-two injuries have been reported as a result of faulty insulin pump cartridges leaking at the side where the plunger is. The leaks can result in the diabetic using the cartridge receiving a lower insulin dosage than they intended.

Johnson & Johnson has posted an urgent notice on their Animus division website warning consumers to check their cartridge supply and to stop using any of the 2.0 ml cartridges in question immediately. It is also contacting insulin pump users, or as they refer to them, "insulin pumpers", that may have purchased the faulty cartridges, and shipping them replacement cartridges. The website notice reads in part:

Please note that under-delivery of insulin can cause high blood sugar and/or diabetic ketoacidosis. These are serious conditions that can cause severe health impact, including death. Symptoms of diabetic ketoacidosis may include nausea, vomiting, shortness of breath and excess thirst/urination. Contact your healthcare professional immediately if you are experiencing any of these symptoms.

Ketoacidosis usually develops slowly over 24 hours, starting with symptoms such as fatigue, mental stupor, decreased appetite, loss of appetite, headache, and fading consciousness. Other ketoacidosis symptoms all insulin dependent diabetics should be aware of include stomach or abdominal pain, a flushed complexion, and breath that smells like fruit or nail polish remover.

The insulin cartridge recall extends to the US and France. The recall applies only to lot numbers B201575, B201576, B201581, B201582 and B201583. The insulin pump cartridges in questions were shipped between November 30th, 2010 and January 4th, 2011.

Animas has provided the following instructions for insulin pumpers diabetics with a recalled insulin cartridge who need to disconnect their infusion sets:

1) Disconnect the infusion set from your body (failure to follow these important safety instructions can lead to unintended delivery of insulin).

2) Unscrew the cartridge cap, leaving the tubing connected to the cartridge.

3) With the tubing connected to the cartridge, pull the cartridge straight out of your insulin pump.

4) Disconnect tubing from cartridge, set the cartridge aside to return to Animas.

5) Fill a new cartridge from an unaffected lot not listed above, and attach infusion set tubing.

6) While still disconnected, rewind, load the cartridge and prime.

7) Connect tubing to site once prime is complete.

8)Fill cannula only if you have inserted a new infusion set.

Animas Customer Support can also be reached by phone toll-free at 877-937-7867.

Giving Your Cat Insulin Injections

March 14th, 2011

cat in gardenIf you have experience with feline diabetes you know how hard it can be to watch your furry family member suffer through weakness, vet appointments, diet changes and, possibly the most challenging of all, insulin injections. Knowledge of proper cat insulin injection techniques can make your life and your cat's life easier. If you have any questions or concerns talk to your vet.

Prepare the Insulin

  • Start by filling the insulin syringe slightly more than your cat's dose
  • Tap the insulin syringe to remove air bubbles
  • Slowly push the plunger until you have the correct dosage of insulin in the syringe

Prepare Your Cat

Create a routine to make your cat comfortable. At first he will likely try to get away, but eventually he should become familiar with the process, and you may even be able to train him to come when it is time for his insulin injection. Start by giving him lots of attention and affection, and maybe even a small treat. It is probably best to keep the insulin syringe out of your hands at first, so that he does not get scared. When you are ready to give your cat insulin, get on his level - don't come at him from above or he will feel threatened. Now it is time to find the injection site.

Injection sites

The scruff (top of the neck) is the most commonly used injection site for insulin for cats, however it may not be the best. The amount of skin and muscle in this area can slow absorption of the insulin, and can be more painful for the cat.

Other options for injection are the flank (between the ribs and the legs), the side or underside of the belly, and the side of the chest. Absorption tends to be quickest when given in the side or underside of the belly.

Insulin Injection

Each cat is different, and the proper type, dose and frequency of insulin for cats need to be determined by a veterinarian. Once you know the proper insulin dosing and have determined the best place for injection, place your thumb and index finger approximately an inch apart and pinch the skin to create a "tent". Make sure you are not grabbing any muscle.

The insulin injection should go into the hollow space under the "tent" of skin. It should not go into the skin itself, or into the muscle. If your cat is long-haired make sure that you can see the skin and that you are not giving him a "fur shot".

When you are giving the insulin injection be confident, smooth and fast. It is the puncture part that hurts, so go quickly through that part; you can slow down a bit while you inject the fluid.

Above all, be gentle and kind when giving your cat insulin, especially at first, and praise him when it is all done.

Artificial Pancreas Awaiting FDA Approval for Clinical Testing

March 26th, 2011

The artificial pancreas is a unique combination of three main closed-loop components:

1) A continuous glucose monitor for ongoing blood sugar levels and patterns

2) A programmable computerized insulin pump

3) An advanced computer algorithm (formula) that can calculate how much insulin the body needs, and when it needs it

Although just the "research and development first step" towards a fully functioning artificial pancreas, the insulin delivery system now awaiting approval for clinical trials is, according to Animas' Chief Medical Officer and director of Project Manya, Dr. Henry Anhalt, "leaps and bounds above technology that is currently available."

Anholt points out that current insulin pumps, which he calls "unintelligent", can monitor blood glucose and dispense insulin, but still require users to input and interpret a lot of data. While some decisions will still have to be made by users until the device is fully automated, Anholt says the new artificial pancreas can "assist the patient and in many ways, take over the decision-making process".

Once perfected, the new technology will have a monumental impact on the quality of life of insulin dependent diabetics. Not only will the new insulin delivery system simplify the constant challenge of controlling blood sugar, accurate insulin dosing and administering insulin injections, the resulting tight blood sugar control will help ward off a host of diabetes complications such as blindness, nerve damage, amputations and kidney and heart disease.

Artificial Pancreas Awaiting FDA Approval for Clinical Testing

March 26th, 2011

The artificial pancreas is a unique combination of three main closed-loop components:

1) A continuous glucose monitor for ongoing blood sugar levels and patterns

2) A programmable computerized insulin pump

3) An advanced computer algorithm (formula) that can calculate how much insulin the body needs, and when it needs it

Although just the "research and development first step" towards a fully functioning artificial pancreas, the insulin delivery system now awaiting approval for clinical trials is, according to Animas' Chief Medical Officer and director of Project Manya, Dr. Henry Anhalt, "leaps and bounds above technology that is currently available."

Anholt points out that current insulin pumps, which he calls "unintelligent", can monitor blood glucose and dispense insulin, but still require users to input and interpret a lot of data. While some decisions will still have to be made by users until the device is fully automated, Anholt says the new artificial pancreas can "assist the patient and in many ways, take over the decision-making process".

Once perfected, the new technology will have a monumental impact on the quality of life of insulin dependent diabetics. Not only will the new insulin delivery system simplify the constant challenge of controlling blood sugar, accurate insulin dosing and administering insulin injections, the resulting tight blood sugar control will help ward off a host of diabetes complications such as blindness, nerve damage, amputations and kidney and heart disease.

Frequently Asked Questions About Insulin Pumps

April 1st, 2011

insulin pump
About.com type 1 diabetes guide Gary Gilles believes that insulin pump therapy has changed the way people with insulin dependent diabetes handle their condition. Gilles, a health writer and diabetes counselor, has put together a helpful list of FAQ's on insulin pump therapy, answering inquiries from the basic "What is an insulin pump?" to questions about their safety, effectiveness and how to program and troubleshoot an insulin pump.

Click >HERE< to read Gilles' insulin pump FAQ's on About.com. Gilles' article links to related posts on the pros and cons of insulin pump therapy, types of insulin pumps, and the latest research.

Frequently Asked Questions About Insulin Pumps

April 1st, 2011

insulin pump
About.com type 1 diabetes guide Gary Gilles believes that insulin pump therapy has changed the way people with insulin dependent diabetes handle their condition. Gilles, a health writer and diabetes counselor, has put together a helpful list of FAQ's on insulin pump therapy, answering inquiries from the basic "What is an insulin pump?" to questions about their safety, effectiveness and how to program and troubleshoot an insulin pump.

Click >HERE< to read Gilles' insulin pump FAQ's on About.com. Gilles' article links to related posts on the pros and cons of insulin pump therapy, types of insulin pumps, and the latest research.

Insulin Therapy Changing With New and Improved Insulin Delivery Methods

April 14th, 2011

An old insulin syringe
Not that long ago, being insulin dependent meant you had to carry around a syringe and a vial of insulin to deliver your insulin injections, making sure to keep them refrigerated. There are now a variety of methods for insulin delivery on the market, and some promising new developments on the horizon. These include:

1) Insulin pens. Most types of insulin are now available in convenient prefilled pens. Some insulin pens are entirely disposable when empty, and others use a replaceable insulin cartridge, usually containing 300 units. There is a dial on one end to set your desired dose. The pens offer discreet, push button insulin delivery. Some claim the injections are more comfortable than from a needle that has already been dulled by insertion into an insulin vial. Many people prefer to use an insulin pen if they are caring for a diabetic child or pet.

2) Insulin pumps. Insulin pumps are a device about the size of a pager that adhere to the skin and are worn 24/7. Insulin pumps contain an insulin reservoir, a battery powered pump, and a programmable computer chip that allows the user to control insulin dosing.

The pumps is attached to a thin plastic tube called a cannula, which is inserted just under the skin to deliver insulin subcutaneously and continuously. Insulin pump technology is constantly being improved upon. The newer pumps are smaller, and can "communicate" and interact with a continuous blood glucose monitor and computer software for state of the art blood sugar control.

3) Insulin jet injectors. Insulin jet injectors deliver a fine jet of high pressure insulin directly through the skin. The main advantage is that that the insulin delivery system requires no needles. The major disadvantage is that many diabetics find the force required for the insulin to permeate the skin is painful, and may cause bruising. Jet injectors have been on the market since 1979, but have yet to become popular.

4) Insulin patch. The FDA has just approved a new insulin delivery patch. The new device, Finesse, is a small plastic patch-pen roughly 2 inches long and an inch wide that is attached to the skin like a bandage. It can be worn under your clothes, and remains attached during routine activities like sleeping, exercising and even showering.

Patients use a syringe to pre-fill the patch-pen with a three-day supply of insulin, and simply push two buttons to dispense a dose of fast-acting insulin when needed. The insulin is delivered in seconds through a miniature, flexible plastic tube inserted painlessly into the skin. The manufacturer, Calibra is also working on a patch-pen that would deliver a .05 unit insulin dose for children.

5) Inhaled insulin. The FDA approved the first insulin inhaler, Exubera, in 2006. It was a short-acting insulin delivered to the lungs through a device similar to an asthma inhaler. But it never achieved market success, and was discontinued a year later.

But research on inhaled insulin continued, and two new forms are poised to hit the market. One is an insulin inhaler, AFREZZA, which is awaiting FDA approval. The other is an insulin spray which is absorbed through the mouth, called Oral-Lyn. Oral-Lyn is in Phase 111 clinical trials in Europe and North America.

Despite some obvious advantages to the new insulin delivery methods, tried and true insulin syringes remain the most popular way to deliver insulin injections with most insulin dependent diabetics, who no longer consider injections a big deal.

Insulin pens, insulin pumps, and insulin jet injectors are all more costly than insulin syringes, and not always covered by medical insurance.Not all types of insulin are available in insulin pens, and you can't mix insulin types in a pen.

Insulin pumps can kink or otherwise malfunction, posing the danger of inaccurate insulin dosing, and are just too "high tech" for some diabetics. Many diabetics remain skeptical of devices like insulin inhalers and sprays after Exubera's spectacular lack of success.

Still, with the advances being made in insulin pumps, and the pending introduction of an improved inhaled insulin and the insulin patch, the world of insulin therapy is definitely changing - and most would say for the better.

Insulin Therapy Changing With New and Improved Insulin Delivery Methods

April 14th, 2011

An old insulin syringe
Not that long ago, being insulin dependent meant you had to carry around a syringe and a vial of insulin to deliver your insulin injections, making sure to keep them refrigerated. There are now a variety of methods for insulin delivery on the market, and some promising new developments on the horizon. These include:

1) Insulin pens. Most types of insulin are now available in convenient prefilled pens. Some insulin pens are entirely disposable when empty, and others use a replaceable insulin cartridge, usually containing 300 units. There is a dial on one end to set your desired dose. The pens offer discreet, push button insulin delivery. Some claim the injections are more comfortable than from a needle that has already been dulled by insertion into an insulin vial. Many people prefer to use an insulin pen if they are caring for a diabetic child or pet.

2) Insulin pumps. Insulin pumps are a device about the size of a pager that adhere to the skin and are worn 24/7. Insulin pumps contain an insulin reservoir, a battery powered pump, and a programmable computer chip that allows the user to control insulin dosing.

The pumps is attached to a thin plastic tube called a cannula, which is inserted just under the skin to deliver insulin subcutaneously and continuously. Insulin pump technology is constantly being improved upon. The newer pumps are smaller, and can "communicate" and interact with a continuous blood glucose monitor and computer software for state of the art blood sugar control.

3) Insulin jet injectors. Insulin jet injectors deliver a fine jet of high pressure insulin directly through the skin. The main advantage is that that the insulin delivery system requires no needles. The major disadvantage is that many diabetics find the force required for the insulin to permeate the skin is painful, and may cause bruising. Jet injectors have been on the market since 1979, but have yet to become popular.

4) Insulin patch. The FDA has just approved a new insulin delivery patch. The new device, Finesse, is a small plastic patch-pen roughly 2 inches long and an inch wide that is attached to the skin like a bandage. It can be worn under your clothes, and remains attached during routine activities like sleeping, exercising and even showering.

Patients use a syringe to pre-fill the patch-pen with a three-day supply of insulin, and simply push two buttons to dispense a dose of fast-acting insulin when needed. The insulin is delivered in seconds through a miniature, flexible plastic tube inserted painlessly into the skin. The manufacturer, Calibra is also working on a patch-pen that would deliver a .05 unit insulin dose for children.

5) Inhaled insulin. The FDA approved the first insulin inhaler, Exubera, in 2006. It was a short-acting insulin delivered to the lungs through a device similar to an asthma inhaler. But it never achieved market success, and was discontinued a year later.

But research on inhaled insulin continued, and two new forms are poised to hit the market. One is an insulin inhaler, AFREZZA, which is awaiting FDA approval. The other is an insulin spray which is absorbed through the mouth, called Oral-Lyn. Oral-Lyn is in Phase 111 clinical trials in Europe and North America.

Despite some obvious advantages to the new insulin delivery methods, tried and true insulin syringes remain the most popular way to deliver insulin injections with most insulin dependent diabetics, who no longer consider injections a big deal.

Insulin pens, insulin pumps, and insulin jet injectors are all more costly than insulin syringes, and not always covered by medical insurance.Not all types of insulin are available in insulin pens, and you can't mix insulin types in a pen.

Insulin pumps can kink or otherwise malfunction, posing the danger of inaccurate insulin dosing, and are just too "high tech" for some diabetics. Many diabetics remain skeptical of devices like insulin inhalers and sprays after Exubera's spectacular lack of success.

Still, with the advances being made in insulin pumps, and the pending introduction of an improved inhaled insulin and the insulin patch, the world of insulin therapy is definitely changing - and most would say for the better.

The Top Ten Diabetes Research Stories of 2010

April 14th, 2011

neon news sign

According to Gary Gilles, About.com's Diabetes Guide and a health writer, educator and counselor, 2010 was an auspicious year in diabetes research and treatment, with many exciting developments.

Gilles has compiled what he considers to be the Top Ten Diabetes Research Stories of 2010. They include the first generation artificial pancreas, an implantable blood glucose sensor, the world's smallest insulin pen needle, a potential diabetes vaccine, and an organ-like insulin-producing cell pouch implant.

To read more about Gilles top picks in his article on About.com, click >HERE<.

Artificial Pancreas Performs Well in British Trials

April 15th, 2011

model of a pancreas
Pancreas model. Photo: Suleyman Habib
There's good news coming out of Britain for type 1 diabetics. Researchers conducting tests with a closed loop system artificial pancreas were able to better stabilize blood sugar in two groups of study participants than with a conventional insulin pump and - most importantly - to keep their blood sugar from dipping overnight.

An artificial pancreas combines an insulin pump, a continuous glucose monitoring system, and a high tech that provides sophisticated instructions to the insulin pump and glucose monitor depending on blood sugar readings. For example, the computer algorithm computes insulin doses according to rising or falling blood sugar levels, and sends instructions to the insulin pump to deliver the optimum dose. The goal is to have the system act as much as a normal pancreas as possible.

The researchers tested the artificial pancreas in 24 insulin dependent diabetics in two real-life scenarios - an evening meal eaten at home, and a dinner eaten out, including alcohol. Half of the diners were given the artificial pancreas system, while the other half used conventional insulin pump therapy.

To read more on this story online at WebMD, >CLICK HERE.<

Artificial Pancreas Performs Well in British Trials

April 15th, 2011

model of a pancreas
Pancreas model. Photo: Suleyman Habib
There's good news coming out of Britain for type 1 diabetics. Researchers conducting tests with a closed loop system artificial pancreas were able to better stabilize blood sugar in two groups of study participants than with a conventional insulin pump and - most importantly - to keep their blood sugar from dipping overnight.

An artificial pancreas combines an insulin pump, a continuous glucose monitoring system, and a high tech that provides sophisticated instructions to the insulin pump and glucose monitor depending on blood sugar readings. For example, the computer algorithm computes insulin doses according to rising or falling blood sugar levels, and sends instructions to the insulin pump to deliver the optimum dose. The goal is to have the system act as much as a normal pancreas as possible.

The researchers tested the artificial pancreas in 24 insulin dependent diabetics in two real-life scenarios - an evening meal eaten at home, and a dinner eaten out, including alcohol. Half of the diners were given the artificial pancreas system, while the other half used conventional insulin pump therapy.

To read more on this story online at WebMD, >CLICK HERE.<

Oil Refining Expertise Being Applied to Closed Loop Artificial Pancreas

June 15th, 2011

Engineers from the Rensselaer Polytechnic Institute are building on automation techniques used in oil refining to create a closed-loop artificial pancreas for type 1 diabetics. The Institute's Professor B. Wayne Bequette, whose sister developed diabetes early in life, has been fine tuning an increasingly advanced diabetes control system for six years.

The pancreas of a type 1 diabetic produces little or no insulin, leaving them dependent on insulin injections. Blood sugar and insulin levels rise and fall normally during the day, responding to factors like meals, the type of food eaten, stress and exercise. Diabetics must monitor their blood sugar levels frequently, and adjust their insulin dose accordingly.

Bequette's artificial pancreas marries an insulin pump with a continuous glucose monitoring system. The combination quickly and accurately identifies and responds to rapid variations in blood sugar and insulin levels, eliminating the need for frequent testing and guesswork.

To read more about Bequette and his fellow researcher's work on theEngineer >CLICK HERE.<

Oil Refining Expertise Being Applied to Closed Loop Artificial Pancreas

June 15th, 2011

Engineers from the Rensselaer Polytechnic Institute are building on automation techniques used in oil refining to create a closed-loop artificial pancreas for type 1 diabetics. The Institute's Professor B. Wayne Bequette, whose sister developed diabetes early in life, has been fine tuning an increasingly advanced diabetes control system for six years.

The pancreas of a type 1 diabetic produces little or no insulin, leaving them dependent on insulin injections. Blood sugar and insulin levels rise and fall normally during the day, responding to factors like meals, the type of food eaten, stress and exercise. Diabetics must monitor their blood sugar levels frequently, and adjust their insulin dose accordingly.

Bequette's artificial pancreas marries an insulin pump with a continuous glucose monitoring system. The combination quickly and accurately identifies and responds to rapid variations in blood sugar and insulin levels, eliminating the need for frequent testing and guesswork.

To read more about Bequette and his fellow researcher's work on theEngineer >CLICK HERE.<

More Progress Made Towards the Development of an Artificial Pancreas

July 7th, 2011

Researchers are continuing to make progress in the development of an artificial pancreas for insulin dependent type 1 diabetics. An artificial pancreas is an automated, closed-loop system consisting of a continuous glucose monitor, a glucose meter to calibrate the monitor, and an insulin pump.

With the help of a sophisticated computer system, an artificial pancreas produces insulin and controls blood sugar in a diabetic much as a normal pancreas does in a person without diabetes. The sophisticated system senses when the body needs insulin, calculates the dose needed, and delivers automatically, eliminating the need for insulin injections.

To read more about several recent advances towards the development of an artificial pancreas on WebMD, >CLICK HERE<.

Mealtime Insulin Injections May be Replaced by an Insulin Inhaler

August 12th, 2011

There's good news for insulin dependent diabetics who rely on fast-acting mealtime insulin injections to keep their blood sugar under control. MannKind Corporation has the go-ahead to continue clinical testing of its investigational inhaled insulin, AFREZZA. The drug maker and the FDA met to confirm the protocols for two new studies, one in type 1 diabetics, and one in type 2 diabetics.

AFREZZA is an ultra-rapid acting inhaled insulin which uses patented technology to deliver powdered insulin from a thumb-sized device into the lungs. The lungs are an effective option for delivering diabetes medication, largely because of their huge surface area (about the size of a tennis court).MannKind focuses on the discovery, development and commercialization of therapeutic products for patients with diseases such as diabetes and cancer. Now in late stage clinical investigation, AFREEZA is its lead product candidate. Shares of the company jumped 20% at the news that the design of the follow-up clinical trials had been confirmed.

MannKind has been seeking approval for its new generation diabetes medication since March of 2009, but was asked twice to run additional clinical trials in order to provide the FDA with more information. One of the approval delays was due to the drug maker updating the design of its insulin inhaler after applying for approval of the earlier design. The FDA was concerned that there was not enough data to support a switch to the new generation device, and asked that both models be tested together.

Clinical trials of the initial design of the insulin inhaler were promising. Participants reported being pleased with the innovative insulin delivery device, and experienced less hypoglycemia and weight gain than did controls using a standard combination of long-acting insulin glargine and twice a day 70 30 insulin injections.

Insulin can't be taken orally, as digestive juices break it down before it can be used by the body. Currently, the only means of delivering insulin are subcutaneous insulin injections or intravenously. Because AFREEZA is a short-acting mealtime insulin, type 1 diabetics will need to combine it with long-acting insulin injections for complete diabetes control.

Dr. Larry Deeb, a pediatric endocrinologist from the University of Florida College of Medicine, says that failure to comply with regular insulin dosing is one of the major issues in diabetes, often because of the discomfort and inconvenience of insulin injections. Deeb says that finding an alternative insulin delivery method is crucial, especially for children and the needle-phobic.

Should it be approved, AFREEZA would be the second inhaled insulin to hit the market. Pfizer received approval to market a similar product, Exubera, several years ago, but, surprisingly, the product never caught on with diabetics, and was withdrawn from the market a year later.

AFREZZA is easier to use, faster acting and boasts better bioavailability than Exubera, enabling diabetics to achieve more satisfactory insulin levels using smaller amounts. Despite Exubera's unexpected failure, AFREEZA is expected to be a blockbuster diabetes drug when it becomes available.

Mealtime Insulin Injections May be Replaced by an Insulin Inhaler

August 12th, 2011

There's good news for insulin dependent diabetics who rely on fast-acting mealtime insulin injections to keep their blood sugar under control. MannKind Corporation has the go-ahead to continue clinical testing of its investigational inhaled insulin, AFREZZA. The drug maker and the FDA met to confirm the protocols for two new studies, one in type 1 diabetics, and one in type 2 diabetics.

AFREZZA is an ultra-rapid acting inhaled insulin which uses patented technology to deliver powdered insulin from a thumb-sized device into the lungs. The lungs are an effective option for delivering diabetes medication, largely because of their huge surface area (about the size of a tennis court).MannKind focuses on the discovery, development and commercialization of therapeutic products for patients with diseases such as diabetes and cancer. Now in late stage clinical investigation, AFREEZA is its lead product candidate. Shares of the company jumped 20% at the news that the design of the follow-up clinical trials had been confirmed.

MannKind has been seeking approval for its new generation diabetes medication since March of 2009, but was asked twice to run additional clinical trials in order to provide the FDA with more information. One of the approval delays was due to the drug maker updating the design of its insulin inhaler after applying for approval of the earlier design. The FDA was concerned that there was not enough data to support a switch to the new generation device, and asked that both models be tested together.

Clinical trials of the initial design of the insulin inhaler were promising. Participants reported being pleased with the innovative insulin delivery device, and experienced less hypoglycemia and weight gain than did controls using a standard combination of long-acting insulin glargine and twice a day 70 30 insulin injections.

Insulin can't be taken orally, as digestive juices break it down before it can be used by the body. Currently, the only means of delivering insulin are subcutaneous insulin injections or intravenously. Because AFREEZA is a short-acting mealtime insulin, type 1 diabetics will need to combine it with long-acting insulin injections for complete diabetes control.

Dr. Larry Deeb, a pediatric endocrinologist from the University of Florida College of Medicine, says that failure to comply with regular insulin dosing is one of the major issues in diabetes, often because of the discomfort and inconvenience of insulin injections. Deeb says that finding an alternative insulin delivery method is crucial, especially for children and the needle-phobic.

Should it be approved, AFREEZA would be the second inhaled insulin to hit the market. Pfizer received approval to market a similar product, Exubera, several years ago, but, surprisingly, the product never caught on with diabetics, and was withdrawn from the market a year later.

AFREZZA is easier to use, faster acting and boasts better bioavailability than Exubera, enabling diabetics to achieve more satisfactory insulin levels using smaller amounts. Despite Exubera's unexpected failure, AFREEZA is expected to be a blockbuster diabetes drug when it becomes available.

Diabetes Videos on WebMD

August 18th, 2011

More and more people are turning to the web for information on health issues, including diabetes. WebMD is one of the most highly respected sources of timely and trusted medical news and information on the web. The site's Health A to Z section includes a comprehensive Diabetes Health Centre sub-section.

Aware that many people prefer to get their information in other ways rather than reading, WebMD has incorporated a number of alternative means of delivering information into their site, including interactive quizzes, tools such as a Food & Fitness Planner, and short documentary-style videos.

The diabetes-related videos feature real people in real life settings - diabetes patients, parents of diabetic children, researchers, and health care professionals. Currently, the site contains sixty diabetes videos on diverse topics, including:

  • Basic diabetes information (type 1 diabetes, type 2 diabetes, pre-diabetes, diabetes diagnosis, diabetes control, diabetes medication-)

  • Diabetes management (diet, foot care, glucose monitoring, A1C testing, hypoglycemia and hyperglycemia-)

  • Diabetes in children (preschool, young children, adolescents-)

  • Insulin delivery methods (insulin pumps, insulin inhalers, islet cells transplant-)

  • Diabetes research and studies (diabetes vaccine, stem cells, investigational diabetes medications, glucose monitoring tattoo, cord blood study-)

  • New diabetes treatments (islet cells transplant, continuous glucose monitors, botox for foot wounds, silicone eye oil for retinopathy-)

  • Alternative diabetes treatment (vinegar for diabetes, antioxidants, hyperbaric oxygen, medicinal properties of kudzu-)

  • Diabetes complications (foot ulcers, diabetic retinopathy, diabetic neuropathy, diabetes and depression, kidney disease-)

Should a topic be of particular interest, every video is surrounded by links to related in-depth information. To view a WebMD Diabetes Health Centre video on a study on the use of vinegar as a diabetes medication >CLICK HERE.<

How to Give an Insulin Injection

August 29th, 2011

For those newly diagnosed insulin dependent diabetics, or those caring for someone newly diagnosed, WebMD has developed a six-step "Action Set" on giving an insulin injection to your self or to someone else.

The instructional guide, found online in the Diabetes Health Center, starts with basic information on insulin therapy, and then leads into detailed information on preparing an insulin dose and giving an insulin injection. The information links to illustrative slideshows demonstrating the techniques.

>CLICK HERE< to view the Action Set and slideshows on giving an insulin shot on WebMD.

Flying Can Cause Changes in Insulin Pump Performance

August 30th, 2011

Diabeticlive.com is warning insulin dependent diabetes planning to take a plane that changes in cabin air pressure while flying may alter the functioning of insulin pumps. The research arose out of an incident involving a young diabetic traveler using an insulin pump whose blood sugar levels dropped unexpectedly one hour into a flight.

After uncovering reports of similar incidents involving insulin pumps delivering incorrect insulin doses while being used on planes, a team of researchers from John Hunter Children's Hospital in Australia decided to perform some tests.

They placed ten insulin pumps on a commercial flight. When they analyzed them later, they found the pumps delivered 1 to 1.4 extra units of insulin after take-off, and that a small amount of insulin was drawn back into the pumps when descending for a landing.

To read the entire story on diabeticlive.com, including the researchers' suggestions for diabetics with insulin pumps who plan to travel byplane, >CLICK HERE.<

Does Using Long Acting Insulin Increase Cancer Risk?

September 6th, 2011

long acting insulin

According to the FDA, five recent studies of a possible link between insulin glargine (marketed as Lantus long acting insulin) and the growth of cancerous cells have failed to shed more light on the subject. Calling the studies "inconclusive", the FDA said it was continuing to work with the long acting insulin manufacturer, Sanofi-Aventus, to determine whether there is an increased risk of cancer for users of insulin glargine.

The concerns arose because Lantus' ability to act as a long acting insulin arises from its prolonged interaction with the insulin-like growth factor-I receptor (IGF-IR). IGF-IR overactivity has been linked to many types of cancer. That begs the question - could long acting insulin glargine be associated with cancer because of its continual interfacing with IGF-IR?

While the debate about the possible cancer risk associated with long acting insulin continues, the American Diabetes Association, the American Association of Clinical Endocrinologists and two similar European governing bodies are reassuring insulin dependent diabetics that there is no need to change their insulin glargine treatment.

To read more about the controversial long-acting Lantus insulin clinical studies on diabeticlive.com, >CLICK HERE.<

Insulin Jet Injectors Evolving

September 12th, 2011

Despite lackluster success to date, the market research firm Kalorama is predicting that the worldwide market for jet injectors will double over the next five years. Jet injectors are a needleless drug delivery system that distribute a fine jet of medication under such high pressure that it is able to penetrate the skin.

"Needle-free devices have come a long way to the present state and are playing an increasingly important role in the novel drug delivery technology markets," Kalorama drug delivery analyst Mary Anne Crandall wrote in a report titled Needle-Free Drug Delivery Markets. She predicts that their ease of use, safety and cost effectiveness, combined with evolving technology, will result in a future boom in jet injector sales.

"Needle free has been a part of insulin marketing for some time," says Crandall, "And now we are also seeing it with vaccines and [other] treatments." There are now over a dozen FDA approved needle-free jet injectors on the market, most designed for specific purposes such as administering vaccines, delivering hormone treatments, and administering growth hormone to children.

Bioject's VitaJet has traditionally been marketed as an insulin jet injector, although it is now being promoted for other home injection applications. There are insulin jet injectors specially designed for children, and even one for dogs and cats, the Zoe Pet Jet.

There are still some limitations to widespread usage of jet injectors. For example, jet injectors can't efficiently administer drugs intramuscularly. They are well suited to delivering subcutaneous insulin doses, but existing jet injectors are cumbersome compared to an insulin syringe or insulin pen, and require maintenance.

Currently, cost is also an issue, although Crandall believes prices will erode in the near future, spurring further sales. While initially expensive, jet injectors are designed to last for years. The pressurized gas cartridges needed to power many jet injectors (others use a spring loaded device) are an ongoing expense.

The number one issue may be discomfort. Although some diabetics find a needleless insulin injection quite tolerable, many find the pressure required to force the insulin through the skin painful. Some report bruising, swelling and even bleeding at the injection site, although that may be the result of an incorrect injector setting.

There are some obvious benefits to a needle free jet injection system, the most apparent being the option for the needle phobic to avoid needles. Other advantages are the speed and ease of use, safety (no bent or broken needles, or "sharps" to dispose of ), less risk of contamination, a better spread of insulin into the subcutaneous tissue, no scar tissue build up at the injection site, and no need to keep buying syringes.

"Needle-free jet injection devices can and should play a major role in solving the problems of needle stick injuries and needle phobia in the United States," according to Crandall. With the industry aware of and working on the drawbacks of the promising drug delivery devices, Crandall is probably right.

New Disposable Insulin Delivery Device About to Hit the Market

September 14th, 2011

Valeritas, an American medical technology company focused on the development and commercialization of innovative drug delivery solutions, is poised to begin marketing a new disposable insulin delivery device called the V-Go Disposable Insulin Delivery Device.

The V-Go is designed to provide an alternative to multiple daily insulin injections for adult type 2 diabetics using basal-bolus insulin therapy. The V-Go delivers a continuous preset rate of basal insulin (20, 30 or 40 units of insulin per 24 hours) and allows for on demand bolus dosing at mealtimes (in two unit increments up to 36 units).

Users fill the V-Go with their desired insulin dose using an included disposable filling accessory, the V-Go EZ Fill. The small, lightweight (about 1 ounce when full) device delivers insulin subcutaneously for 24 hours, after which it is replaced with a new one. The discreet device is worn under a patient's clothing, and should not be exposed to direct sunlight or high temperatures, although it can be submerged in up to three feet of water.

The non-electronic V-Go was tested using both Humalog insulin lispro and Novolog (insulin aspart), and achieved FDA approval at the end of 2010. The company has been pursuing financing to market it ever since, and has just announced that it has raised $150 million to bring the V-Go Disposable Insulin Delivery Device to market.

"Millions of adult patients suffer from type 2 diabetes and require insulin," says Valeritas CEO Kristine Peterson, "We believe the V-Go will be an important treatment option to assist in the management of their diabetes." To visit the V-Go site and to sign up for email updates on the availability of the innovative insulin delivery device, >Click Here.<

New Disposable Insulin Delivery Device About to Hit the Market

September 14th, 2011

Valeritas, an American medical technology company focused on the development and commercialization of innovative drug delivery solutions, is poised to begin marketing a new disposable insulin delivery device called the V-Go Disposable Insulin Delivery Device.

The V-Go is designed to provide an alternative to multiple daily insulin injections for adult type 2 diabetics using basal-bolus insulin therapy. The V-Go delivers a continuous preset rate of basal insulin (20, 30 or 40 units of insulin per 24 hours) and allows for on demand bolus dosing at mealtimes (in two unit increments up to 36 units).

Users fill the V-Go with their desired insulin dose using an included disposable filling accessory, the V-Go EZ Fill. The small, lightweight (about 1 ounce when full) device delivers insulin subcutaneously for 24 hours, after which it is replaced with a new one. The discreet device is worn under a patient's clothing, and should not be exposed to direct sunlight or high temperatures, although it can be submerged in up to three feet of water.

The non-electronic V-Go was tested using both Humalog insulin lispro and Novolog (insulin aspart), and achieved FDA approval at the end of 2010. The company has been pursuing financing to market it ever since, and has just announced that it has raised $150 million to bring the V-Go Disposable Insulin Delivery Device to market.

"Millions of adult patients suffer from type 2 diabetes and require insulin," says Valeritas CEO Kristine Peterson, "We believe the V-Go will be an important treatment option to assist in the management of their diabetes." To visit the V-Go site and to sign up for email updates on the availability of the innovative insulin delivery device, >Click Here.<

Overcoming Injection Anxiety

September 20th, 2011

Have you or someone close to you been newly diagnosed as an insulin dependent diabetic? Are you anxious about giving yourself or your dependent insulin injections? Many diabetics say that giving themselves an insulin injection is the hardest part of the condition.

Or perhaps you're an experienced diabetic who hasn't kept up to date on the latest insulin delivery methods like spring loaded syringes, insulin pens and insulin jet injectors. Skipping doses of diabetes medication can lead to poor blood sugar control and diabetes complications. WebMD feature writer Stephanie Watson offers some practical advice in an article titled Overcoming Objections to Injections.

Overcoming Injection Anxiety

September 20th, 2011

Have you or someone close to you been newly diagnosed as an insulin dependent diabetic? Are you anxious about giving yourself or your dependent insulin injections? Many diabetics say that giving themselves an insulin injection is the hardest part of the condition.

Or perhaps you're an experienced diabetic who hasn't kept up to date on the latest insulin delivery methods like spring loaded syringes, insulin pens and insulin jet injectors. Skipping doses of diabetes medication can lead to poor blood sugar control and diabetes complications. WebMD feature writer Stephanie Watson offers some practical advice in an article titled Overcoming Objections to Injections.

Edible Film a Possible Insulin Delivery Platform

September 22nd, 2011

In another promising development in the world of diabetes medication, the specialty pharmaceutical company MonoSol Rx is testing its unique PharmFilm as a possible oral insulin delivery platform. PharmFilm is a quick-dissolving film that can be impregnated with medication and placed under the tongue or against the inside of the cheek. The medication is quickly absorbed into the bloodstream through the mouth's mucosal membranes.

The FDA has already approved two applications of the edible film - Zuplenz to treat nausea and vomiting, and Suboxone to treat opiod dependence. MonoSol Rx is now testing two new applications for PharmFilm, one dispenses a drug to treat ADHD, and the other delivers insulin for diabetics.

Currently, insulin can only be administered through injection, as it is destroyed by acids in the digestive system. Because the postage stamp sized insulin film dissolves so quickly in the mouth, the diabetes medication bypasses the digestive tract and passes directly into the circulatory system.

MonoSol Rx and Midatech are just two of many companies racing to develop different ways to administer insulin without injections, including insulin patches, insulin inhalers, and insulin nasal sprays.

The insulin film can be manufactured in different sizes to accommodate different insulin dosages. The advantages of a dissolving insulin film for insulin dependent diabetics (especially children with diabetes and their caregivers) are obvious - no insulin injections; precise insulin dosing; a convenient, discreet and portable medication, and instant onset of action.

MonoSol Rx is collaborating with Midatech Group Ltd, a leading edge nanotechnology company which develops biocompatible nanoparticles (tiny synthetic molecules that are designed to carry and deliver drugs) to bring the oral diabetes medication to market. The insulin film has been successfully tested transbuccally (inside the cheek) in pigs and monkeys, and the partners plan to begin human trials this year.

A spokesperson for Midatech Group said, "The results of insulin PharmFilm in our primate study validate the film delivery of active insulin across the buccal mucosa for the first time. In addition, we have preclinical proof-of-concept that these results can be achieved in a controlled dose precisely tailored to suit individual needs. We anticipate results from our human clinical trials, slated to commence in the second quarter of 2011, to revolutionize treatment methods and insulin delivery for diabetics worldwide."

According to the Centers for Disease Control, nearly 24 million people in the United States are currently living with diabetes - the seventh leading cause of death in the country. Many of these diabetics (about 30%) are, or will become, insulin dependent and require insulin injections. Many are struggling with complications involving their heart, kidneys, nerves, eyes, and circulation.

Insulin is a hormone which moves blood sugar into the cells to give the body energy. Diabetics either don't produce any insulin (type 1 diabetes), can't make enough insulin, and/or can't properly make use of the little insulin they do produce (type 2 diabetes).

Edible Film a Possible Insulin Delivery Platform

September 22nd, 2011

In another promising development in the world of diabetes medication, the specialty pharmaceutical company MonoSol Rx is testing its unique PharmFilm as a possible oral insulin delivery platform. PharmFilm is a quick-dissolving film that can be impregnated with medication and placed under the tongue or against the inside of the cheek. The medication is quickly absorbed into the bloodstream through the mouth's mucosal membranes.

The FDA has already approved two applications of the edible film - Zuplenz to treat nausea and vomiting, and Suboxone to treat opiod dependence. MonoSol Rx is now testing two new applications for PharmFilm, one dispenses a drug to treat ADHD, and the other delivers insulin for diabetics.

Currently, insulin can only be administered through injection, as it is destroyed by acids in the digestive system. Because the postage stamp sized insulin film dissolves so quickly in the mouth, the diabetes medication bypasses the digestive tract and passes directly into the circulatory system.

MonoSol Rx and Midatech are just two of many companies racing to develop different ways to administer insulin without injections, including insulin patches, insulin inhalers, and insulin nasal sprays.

The insulin film can be manufactured in different sizes to accommodate different insulin dosages. The advantages of a dissolving insulin film for insulin dependent diabetics (especially children with diabetes and their caregivers) are obvious - no insulin injections; precise insulin dosing; a convenient, discreet and portable medication, and instant onset of action.

MonoSol Rx is collaborating with Midatech Group Ltd, a leading edge nanotechnology company which develops biocompatible nanoparticles (tiny synthetic molecules that are designed to carry and deliver drugs) to bring the oral diabetes medication to market. The insulin film has been successfully tested transbuccally (inside the cheek) in pigs and monkeys, and the partners plan to begin human trials this year.

A spokesperson for Midatech Group said, "The results of insulin PharmFilm in our primate study validate the film delivery of active insulin across the buccal mucosa for the first time. In addition, we have preclinical proof-of-concept that these results can be achieved in a controlled dose precisely tailored to suit individual needs. We anticipate results from our human clinical trials, slated to commence in the second quarter of 2011, to revolutionize treatment methods and insulin delivery for diabetics worldwide."

According to the Centers for Disease Control, nearly 24 million people in the United States are currently living with diabetes - the seventh leading cause of death in the country. Many of these diabetics (about 30%) are, or will become, insulin dependent and require insulin injections. Many are struggling with complications involving their heart, kidneys, nerves, eyes, and circulation.

Insulin is a hormone which moves blood sugar into the cells to give the body energy. Diabetics either don't produce any insulin (type 1 diabetes), can't make enough insulin, and/or can't properly make use of the little insulin they do produce (type 2 diabetes).

Is It Safe To Reuse An Insulin Syringe?

September 30th, 2011

Is it safe to reuse an insulin syringe? Bethany from California asked this question of Conditions Expert Dr. Otis Brawley on the health website CNN Health. Dr. Otis' answer reads in part:

"Insulin syringes are expensive, and many patients want to reuse needles to save money. Many also reuse the lancets used to prick the skin and draw blood to measure blood sugar.

You are right that the reuse of insulin syringes and lancets is dangerous. A used needle can have bacteria from the skin in and on it. Bacteria can contaminate the bottle of insulin when reinserted into the bottle. The bottled insulin is a growth medium that can allow the bacteria to reproduce. Insulin is stored in a refrigerator to prevent bacterial growth.

Certain types of bacteria when injected can be especially devastating and can even cause death. In the U.S., several thousand diabetic patients die each year due to bad sterile technique causing abscesses, skin infection and sepsis, which is generalized infection involving the blood.

There are some insulin injection devices that are designed to be reused. Insulin for these devices comes in cartridges with a needle. A new cartridge and needle is used with each dose. The cartridge system is not very useful for the patients who have to mix immediate and long acting insulin at a dose.

All of these risks [of diabetes complications] can be reduced through good blood sugar control, good diet, exercise, and taking diabetes medications properly. Mild diabetes can be controlled through diet and exercise. Moderate disease often requires oral diabetes medications, and more severe Type 2 disease requires oral diabetes medicines and insulin injections."

To read Dr. Otis' answer in its entirety, including sound advice on avoiding diabetes complications, >Click Here.<

Novo Nordisk Files for Approval of Ultra Long Acting Insulin

October 5th, 2011

Insulin

Novo Nordisk today announced the submission to the U.S. Food and Drug Administration of two new drug applications for ultra-long-acting insulin degludec and the co-formulation, insulin degludec/insulin aspart. These insulin analogs have been developed for the treatment of people with type 1 and type 2 diabetes.

"We are very excited about being able to file for the approval of insulin degludec and insulin degludec/insulin aspart now also in the US," said Mads Krogsgaard Thomsen, Executive Vice President and Chief Science Officer at Novo Nordisk. "This is another significant milestone for Novo Nordisk and for the millions of people with diabetes who require insulin injections."

As with the European applications submitted on September 26, the U.S. filings are based on results from the BEGIN and BOOST clinical trial programs, which involved nearly 10,000 type 1 and type 2 diabetes patients. Data from the trials have shown insulin degludec to lower blood glucose levels, while demonstrating a low rate of hypoglycemia, especially at night.

The trials also showed that insulin degludec can be administered once daily at any time of the day with the possibility to change the insulin injection time from day to day according to the needs of the individual patient.

Novo Nordisk intends to make both diabetes medications available in a prefilled insulin delivery device. In the clinical trials, insulin degludec was studied in insulin pens that could either deliver up to 80 units or in a concentrated formulation up to 160 units in a single injection.

Insulin degludec is an ultra-long-acting basal insulin analog discovered and developed by Novo Nordisk. It forms multi-hexamers upon subcutaneous injection, resulting in a soluble depot from which there is a slow, continuous and extended release of insulin degludec. This may contribute to a lowering of blood glucose levels and low rates of hypoglycemia, especially at night.

Insulin degludec/insulin aspart contains the ultra-long-acting basal insulin degludec with a bolus boost of insulin aspart. Insulin degludec/insulin aspart is the first and only soluble insulin co-formulation of ultra-long-acting insulin degludec and insulin aspart providing both fasting and post-prandial control.

Novo Nordisk Files for Approval of Ultra Long Acting Insulin

October 5th, 2011

Insulin

Novo Nordisk today announced the submission to the U.S. Food and Drug Administration of two new drug applications for ultra-long-acting insulin degludec and the co-formulation, insulin degludec/insulin aspart. These insulin analogs have been developed for the treatment of people with type 1 and type 2 diabetes.

"We are very excited about being able to file for the approval of insulin degludec and insulin degludec/insulin aspart now also in the US," said Mads Krogsgaard Thomsen, Executive Vice President and Chief Science Officer at Novo Nordisk. "This is another significant milestone for Novo Nordisk and for the millions of people with diabetes who require insulin injections."

As with the European applications submitted on September 26, the U.S. filings are based on results from the BEGIN and BOOST clinical trial programs, which involved nearly 10,000 type 1 and type 2 diabetes patients. Data from the trials have shown insulin degludec to lower blood glucose levels, while demonstrating a low rate of hypoglycemia, especially at night.

The trials also showed that insulin degludec can be administered once daily at any time of the day with the possibility to change the insulin injection time from day to day according to the needs of the individual patient.

Novo Nordisk intends to make both diabetes medications available in a prefilled insulin delivery device. In the clinical trials, insulin degludec was studied in insulin pens that could either deliver up to 80 units or in a concentrated formulation up to 160 units in a single injection.

Insulin degludec is an ultra-long-acting basal insulin analog discovered and developed by Novo Nordisk. It forms multi-hexamers upon subcutaneous injection, resulting in a soluble depot from which there is a slow, continuous and extended release of insulin degludec. This may contribute to a lowering of blood glucose levels and low rates of hypoglycemia, especially at night.

Insulin degludec/insulin aspart contains the ultra-long-acting basal insulin degludec with a bolus boost of insulin aspart. Insulin degludec/insulin aspart is the first and only soluble insulin co-formulation of ultra-long-acting insulin degludec and insulin aspart providing both fasting and post-prandial control.

Should You Take a "Vacation" From Your Insulin Pump?

October 6th, 2011

insulin syringe

A veteran insulin pump user wrote a thought-provoking post for HealthCentral.com about "taking a vacation" from insulin pumping. It begins:

By Kelsey Bonilia

"One of the ideas I'd been mulling over in the weeks leading up to my endocrinologist appointment was taking a pump vacation.I'd experienced several frustrating pump site malfunctions (the cannula kept kinking during insertion) that left me with stubbornly high blood sugars for hours.It was maddening to have poor blood sugar control because of my insulin delivery system.Also, after nearly five years of insulin pumping, I just wanted the freedom of life without a little medical device tethered to me.

Upon discussion with my doctor, I made the comment "I know that the pump is best..." to which he replied, "For some people, but it's not inherently better." He knows that I eat a fairly disciplined diet and still test my blood sugar 10-12 times a day, so he agreed that switching to insulin injections would be fine for me. He prescribed Humalog and Lantus insulin pens, which I'd never used before.It was kind of exciting to open the boxes of pens and learn how to use a new device!"

Kelsey plans to update the pros and cons of switching to insulin injections after using an insulin pump for almost five years. To read this and future posts on HealthCentral.com, >Click Here.<

Should You Take a "Vacation" From Your Insulin Pump?

October 6th, 2011

insulin syringe

A veteran insulin pump user wrote a thought-provoking post for HealthCentral.com about "taking a vacation" from insulin pumping. It begins:

By Kelsey Bonilia

"One of the ideas I'd been mulling over in the weeks leading up to my endocrinologist appointment was taking a pump vacation.I'd experienced several frustrating pump site malfunctions (the cannula kept kinking during insertion) that left me with stubbornly high blood sugars for hours.It was maddening to have poor blood sugar control because of my insulin delivery system.Also, after nearly five years of insulin pumping, I just wanted the freedom of life without a little medical device tethered to me.

Upon discussion with my doctor, I made the comment "I know that the pump is best..." to which he replied, "For some people, but it's not inherently better." He knows that I eat a fairly disciplined diet and still test my blood sugar 10-12 times a day, so he agreed that switching to insulin injections would be fine for me. He prescribed Humalog and Lantus insulin pens, which I'd never used before.It was kind of exciting to open the boxes of pens and learn how to use a new device!"

Kelsey plans to update the pros and cons of switching to insulin injections after using an insulin pump for almost five years. To read this and future posts on HealthCentral.com, >Click Here.<