Experts have dwelt at length on the various devices available in a Special Supplement to Diabetes Technologs y & Therapeutics, a peer-reviewed journal published by Mary Ann Liebert, Inc. (http://www.liebertpub.com). The issue is available free online (http://www.liebertpub.com/dia).
"Improved delivery devices for insulin treatment have increased patient compliance and acceptance of an intensive insulin strategy," which can result in significant reductions in long-term complications associated with poorly controlled type 1 and type 2 diabetes, says Satish Garg, MD, Professor of Medicine and Pediatrics at the University of Colorado Denver, in his Editorial entitled "Impact of Insulin Delivery Devices in Diabetes Care."
The development of automated glucose-controlled insulin infusion systems that combine the advantages of continuous glucose measurement with intravenous insulin infusion pumps "is likely to explode over the next several years," predicts Jay Skyler, MD, Professor of Medicine, Pediatrics, and Psychology at the University of Miami Miller School of Medicine (Florida), in the article, "Continuous Subcutaneous Insulin Infusion An Historical Perspective."
Although insulin pump and pen technology have been available for quite some time, these devices are "underused, misused, or poorly used," says Irl Hirsch, MD, from the University of Washington School of Medicine (Seattle). In his Concluding Remarks, "Insulin Delivery Devices Pumps and Pens," he reviews the reasons for the poor use of diabetes technology worldwide and predicts increased adoption of these treatment devices in the coming decade.
Eric Renard, MD, PhD, from the University of Montpellier (France), presents the factors he believes have limited insulin pump use in Europe and the need for expanded insurance coverage and education to drive increased adoption of the technology. Bruce Bode, MD, a diabetes specialist with Atlanta Diabetes Associates (Georgia), describes the promise and advantages insulin pumps offer for improving glucose control in type 2 diabetes, based on early-stage clinical research in this area.
Riccardo Perfetti, MD, PhD, from Sanofi-Aventis (Paris, France), explores the reasons for the marked geographical variation in the use of reusable and disposable insulin pens and concludes that the most important factor is likely varied access to the devices in different regions of the world. Perfetti also suggests that insulin pens have potential benefit for use in hospitalized patients, an application that has received too little attention.
Diabetes Technology & Therapeutics is a peer-reviewed journal published monthly that covers new technology and new products for the treatment, monitoring, diagnosis, and prevention of diabetes and its complications. Technologies include noninvasive glucose monitoring, implantable continuous glucose sensors, novel routes of insulin administration, genetic engineering, the artificial pancreas, measures of long-term control, computer applications for case management, telemedicine, the Internet, and new medications.