title: Faster pharmacokinetics and increased patient acceptance of intradermal insulin delivery using a single hollow microneedle in children and adolescents with type 1 diabetes.
abstract: OBJECTIVE
  In an effort to improve compliance with insulin therapy and to accelerate insulin pharmacokinetics, we tested the hypothesis that intradermal insulin delivery using a hollow microneedle causes less pain and leads to faster onset and offset of insulin pharmacokinetics in children and adolescents with type 1 diabetes (T1DM) compared with a subcutaneous, insulin pump catheter.
  
  
  METHODS
  In this repeated measures study, 16 children and adolescents with T1DM received Lispro insulin by microneedle and subcutaneous administration on separate days. Subjects rated the pain of insertion and infusion using a visual analog scale. Blood specimens were collected over 4 h to determine insulin and glucose concentrations.
  
  
  RESULTS
  Microneedle insertion pain was significantly lower compared with insertion of the subcutaneous catheter (p = 0.005). Insulin onset time was 22 min faster (p = 0.0004) and offset time was 34 min faster (p = 0.017) after hollow microneedle delivery compared with subcutaneous delivery.
  
  
  CONCLUSIONS
  In this study, intradermal insulin delivery using a single, hollow microneedle device resulted in less insertion pain and faster insulin onset and offset in children and adolescents with T1DM. A reduction in pain might improve compliance with insulin delivery. The faster onset and offset times of insulin action may enable closed-loop insulin therapy.
authors.affiliation: Department of Pediatrics, Division of Endocrinology, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: James J
authors.initials: JJ
authors.lastname: Norman
authors.forename: Milton R
authors.initials: MR
authors.lastname: Brown
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Raviele
authors.forename: Mark R
authors.initials: MR
authors.lastname: Prausnitz
authors.forename: Eric I
authors.initials: EI
authors.lastname: Felner
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001294:Attitude to Health; D002408:Catheters, Indwelling; D002648:Child; D002652:Child Behavior; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism; D016503:Drug Delivery Systems / Q000009:adverse effects*; D005260:Female; D005845:Georgia; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use; D055104:Infusions, Subcutaneous; D007271:Injections, Intradermal; D007332:Insulin Infusion Systems / Q000009:adverse effects; D061268:Insulin Lispro / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use; D008297:Male; D008422:Materials Testing; D009339:Needles; D010147:Pain Measurement
chemical_list: D007004:Hypoglycemic Agents; D061268:Insulin Lispro
keywords: drug-delivery systems; insulin; microneedles; pain; pharmacodynamics; pharmacokinetics