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.
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 and an infusion site. 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.
Read: Insulin pumps may outperform insulin injections
Problems experienced with insulin pumps are:
Hypoglycaemia: (when there's too little glucose in the bloodstream) during the first few months
Changing of tubing and infusion sites: which needs to happen every third day
Cost: pumps and infusion sites are fairly expensive and are not well-covered by most South African medical aid schemes.
As a result, insulin pumps are rarely used in South Africa.
A novel method of insulin administration – via the inhaled route (similar to asthma pumps) – was temporarily taken off the market in 2008 due to safety concerns. In 2014, the FDA approved an inhaled insulin drug, Afrezza for use in the U.S.A.
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