title: A pilot study to examine the tolerability and device preference in type 1 diabetes of insulin aspart administered by InsuJet compared with subcutaneous injection.
abstract: BACKGROUND
  Jet injectors allow needle-free insulin delivery. The study objective was to compare the tolerability and device preference of subcutaneous insulin aspart delivery by jet injector (InsuJet™; European Pharma Group, Schiphol-Rijk, The Netherlands) with pen injection in an open-label, randomized, crossover pilot study.
  
  
  METHODS
  Ten participants with type 1 diabetes underwent two meal tolerance tests 1 week apart. Plasma glucose and serum insulin levels were sampled from 10 min preceding to 240 min after insulin aspart administration by InsuJet or FlexPen(®) (Novo Nordisk Pharmaceuticals Pty. Ltd., Baulkham Hills, NSW, Australia). Insulin dose was calculated using participants' insulin-to-carbohydrate ratios. Immediately after insulin administration, participants drank 500 mL of Ensure(®) (Abbott Australasia Pty. Ltd., Botany, NSW, Australia) (providing 2,240 kJ of energy, 18.6 g of protein, 96 g of carbohydrate, and 3 g of fat).
  
  
  RESULTS
  In this small pilot study, the devices were similar in glucose excursion (median [quartile 1, quartile 3], InsuJet vs. FlexPen, 9.4 [4.8, 12.8] vs. 8.1 [5.4, 10.6] mmol/L; P=0.43), in the area under the glucose concentration-time curve for 0-240 min corrected for baseline glucose level (InsuJet vs. FlexPen, 1,230 [623, 2,012] vs. 1,175 [91, 1,774] mmol · min/L; P=0.4), and in insulin absorption over the 240-min period. Devices were similar for participant preference and relative injection pain.
  
  
  CONCLUSIONS
  Subcutaneous jet injection of aspart insulin was well tolerated.
authors.affiliation: 1 Baker IDI Heart and Diabetes Institute , Melbourne, Victoria, Australia .
authors.forename: Anne T
authors.initials: AT
authors.lastname: Reutens
authors.forename: Beverley
authors.initials: B
authors.lastname: Balkau
authors.forename: Neale
authors.initials: N
authors.lastname: Cohen
mesh_terms: D000328:Adult; D019540:Area Under Curve; D061265:Biphasic Insulins / Q000008:administration & dosage* / Q000493:pharmacokinetics; D001786:Blood Glucose / Q000378:metabolism*; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D016503:Drug Delivery Systems / Q000295:instrumentation* / Q000523:psychology; D005260:Female; D038321:Glycemic Index; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D007279:Injections, Subcutaneous / Q000523:psychology; D061267:Insulin Aspart / Q000008:administration & dosage* / Q000493:pharmacokinetics; D008297:Male; D017060:Patient Satisfaction; D010865:Pilot Projects; D019518:Postprandial Period; D016896:Treatment Outcome
chemical_list: D061265:Biphasic Insulins; D001786:Blood Glucose; D007004:Hypoglycemic Agents; D061267:Insulin Aspart