a. Insulin pens
In type 1 diabetics, insulin is usually administered beneath the skin ("subcutaneously"), using an insulin pen, which may be disposable or reusable.
Most diabetics easily find, or "dial", the prescribed dose of insulin on these user-friendly pens. The added bonus is that the fine bore needles, which are screwed onto these pens, usually don't cause pain.
However, South African state hospitals and clinics frequently supply insulin syringes and insulin vials, which are more difficult to use.
b. Insulin pumps
Insulin pumps are battery-operated pumps that are worn by diabetics and which continuously deliver short- or rapid-acting insulin into the tissue beneath the skin via a narrow gauge tube. This provides a continuous basal supply of insulin at the programmed dose.
At meal times, the diabetic can then dial a bolus of insulin to cover the surge of glucose elevation that's caused by the ingestion of food.
Problems experienced with insulin pumps are:
Hypoglycaemia (when there's too little glucose in the bloodstream) in the first few months
Changing of the tubing, which needs to happen every third day
Cost: these pumps are very expensive.
As a result, insulin pumps are rarely used in South Africa.
c. Inhaled insulin
A novel method of insulin administration – via the inhaled route (similar to asthma pumps) – was taken off the market in 2008 due to safety concerns. Currently there is no inhaled insulin on the market.
Reviewed by Dr Suresh Rajpaul (MbChB, FCPsa)