Insulin pen injection devices for management of patients with type 2 diabetes: considerations based on an endocrinologist's practical experience in the United States.
OBJECTIVE
To review the features of several insulin pens currently available in the United States, discuss the validity of concerns about certain pen devices, and provide specific training information for clinicians to increase the accuracy of insulin administration and patient satisfaction with the use of insulin pens.


METHODS
The published literature on insulin pens and Internet-available, product-specific information are reviewed. In addition, special practical considerations regarding insulin pen selection based on personal experience in a high-volume endocrinology practice are high-lighted by presentation of case vignettes.


RESULTS
For some patients with diabetes, the need for performance of self-injection can be a barrier to acceptance of insulin therapy. Insulin pen devices provide a delivery option that may be more acceptable and more convenient to use in comparison with traditional vials and syringes and thus may promote patient compliance, which can enhance the ability to achieve and maintain glycemic control. When choosing a specific insulin pen for an individual patient, the clinician should consider the patient's insulin regimen, lifestyle, and factors that may affect the ability to use a particular device, such as motor dexterity and visual acuity.


CONCLUSIONS
Insulin pens offer convenience and can potentially increase patient satisfaction and compliance with therapy. Because certain characteristics of a given insulin pen may make it preferable for specific patients, it is important for clinicians to be aware of individual needs. Provision of thorough training for patients in the correct use of insulin pens is important because user error can affect pen performance and accuracy of the dose administered. Manufacturers should be notified of any recurring problems.
Thurman
Jerome E
JE
Division of Endocrinology, Diabetes and Metabolism, Gateway Endocrinology Associates, Saint Louis University School of Medicine, St. Charles, Missouri 63301, USA.
D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004704:Endocrinology / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D007332:Insulin Infusion Systems; D015203:Reproducibility of Results; D014481:United States