January 31, 2014
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Patients with type 2 diabetes prefer pen to vial-and-syringe insulin delivery

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When initiating basal insulin treatment, insulin-naive patients with type 2 diabetes preferred pen over the vial-and-syringe delivery method. Health care providers also recommended the pen device in favor of vial and syringe in a study published in Diabetes Technology and Therapeutics. The study also assessed clinical endpoints and safety outcomes.

Researchers assessed device preference as the primary outcome in 405 insulin-naive patients with type 2 diabetes from 60 centers after a randomized, open-label, crossover design study comparing the two methods of insulin delivery. Patients either used the pen for 2 weeks followed by using vial and syringe for 2 weeks or used vial and syringe for 2 weeks followed by 2 weeks of using the pen. Patient preference was then assessed at the end of the 4 weeks. Patients were further randomly assigned for evaluation at 6, 10 and 30 weeks to observe clinical endpoints.

The patient preference for the pen vs. vial and syringe was significant (P<.001). The pen also was strongly recommended by the health care providers (P<.001). When fasting blood glucose, HbA1c and the incidence of hypoglycemia were compared, they were similar between the two methods. Hypoglycemic events also were comparable.

“Our study revealed a consistent response pattern between [health care provider] recommendations and patient preferences for insulin delivery devices regarding blood glucose control, the reluctance to use insulin, and long-term insulin use. A mutually shared decision process between [health care providers] and patients may improve patient adherence behavior and other patient-reported outcomes,” the researchers wrote.

Disclosure: The study was funded by Sanofi US. Ahmann has served as a consultant to Sanofi US and Novo Nordisk. See the study for a full list of researchers’ financial disclosures.