Microneedle device for intradermal insulin delivery improves the way insulin works in Type 2 diabetes
By Lisa Foster- McNulty, MSN, RN, CDE
There is some early research on Type 2 patients showing that a novel way of administering insulin may give better insulin coverage of meals and help to provide better after meal blood glucose (BG) control in Type 2 patients. In the future, it’s possible that we could all be giving insulin in a different way than we do now. For details, read on!
Although we call our insulins that we use for meal coverage “rapid-acting analogs”, they are slower than molasses in January compared to the action of insulin from a normal pancreas. The result is that it’s common to see a significant BG rise following a meal. Some recent research looked at the effect of injecting the insulin intradermally, which means that it is given just under the top layers of the skin, like when you get a ppd for tuberculosis. They found that it facilitated faster drug absorption and might also improve the way the body metabolizes the insulin, which is called the pharmacokinetics. So injecting the insulin more superficially led to faster insulin absorption and better metabolism of the insulin.
The research, published online on August 8 in Diabetes Technology and Therapeutics, looked at 17 patients with Type 2. The research was done at one center, and it was a pilot study, done as an open label crossover study. The patients were given 0.2 U/kg of Novolog insulin by intradermal (ID injection using a special MicronJet needle. They were also given traditional subcutaneous (SC)injections using a conventional insulin needle in the crossover part of the study. Researchers studied 13 patients under fasting conditions and four patients before a standard meal test. The researchers compared the safety and tolerability of the injections, as well as the pharmacokinetic and pharmacodynamic profiles. Pharmacodynamics refers to what the drug does to the body–the effect of the insulin on blood sugar levels, in this case.
Fourteen patients finished the study. Compared to SC injection, ID injection showed a shorter time for the insulin to be present at maximum concentrations in the blood, while the amount of time it took to reach the peak insulin level after the insulin was given did not significantly differ. The amount of insulin exposure in the first 60 minutes following administration was higher when the insulin was given ID versus SC. The researchers concluded that delivering insulin ID through a MicronJet needle worked better than traditional SC administration through a conventional needle. More insulin was at work sooner after injection and less insulin was at work later in these Type 2 patients. This could help to have better BG control after meals so the BG doesn’t peak so high, keeping things on a more even keel.
This was a small study, and would need to be repeated with larger numbers of participants in well-designed studies before changes would be made to the way you take your insulin. But it’s promising to see that giving the insulin in a different way helped it to provide better after-meal glucose control, and that’s something we can all appreciate!