Trigger matters: an ergonomy analysis of insulin pens

The Review of Insulin Pens-Past, Present, and Look to the Future

Currently, there are about 150-200 million diabetic patients treated with insulin globally. The year 2021 is special because the 100th anniversary of the insulin discovery is being celebrated. It is a good occasion to sum up the insulin pen technology invention and improvement which are nowadays the leading mode of an insulin delivery. Even though so many years have passed, insulin is still administered subcutaneously, that is why devices to deliver it are of great importance. Insulin pens have evolved only through the last decades (the reusable, durable pens, and the disposable, prefilled pens) and modern smart insulin pens have been developed in the last few years, and both types of the devices compared to traditional syringes and vials are more convenient, discrete in use, have better dosing accuracy, and improve adherence. In this review, we will focus on the history of insulin pens and their improvement over the previous decades.

A Multicenter, Prospective, Observational, Open-Label Study of the Safety and Comfort of Gensulin® Delivery Device Use in a Large Cohort of Adult and Elderly Patients with Type 2 Diabetes

Insulin treatment is necessary for many patients with type 2 diabetes, and its delivery must be safe and comfortable. This study evaluated patients' safety and comfort when using a Gensulin® delivery device, GensuPen (Bioton), a reusable insulin pen device for injecting Gensulin® insulin among adult and elderly patients with type 2 diabetes. This was a 4-week multicenter, prospective, observational, open-label study in patients with diabetes mellitus type 2 who have recently started using a GensuPen. Overall, 10,309 patients (mean age: 63 ± 12.0 years; 47.9% female) were analyzed in this study. Of these, 2.5% had used an insulin delivery device before, and for 97.5%, GensuPen was the first delivery device they had used. Most (87.8%) of the patients rated the GensuPen as very good in setting the dose, 92.0% in confirmation of successful insulin administration, 80.9% in trigger location, and 75.0% in force needed for injection. The overall safety of the GensuPen use was high since severe hypoglycemia occurred only in 0.2% of the studied patients. There were 0.6% adverse events, none of which were serious. This real-life observation data shows that the GensuPen was well accepted and safe in this large patient population of adult and elderly patients with type 2 diabetes.

Motorized botulinum toxin injection device: a pilot study on attitudes toward technology-assisted injection in novice and experienced cosmetic practitioners

This study was performed to investigate the user perception of a cordless, motorized electronically controlled delivery system for botulinum toxin type A. Forty-six post-graduate students of varying experience levels of botulinum toxin injections and four members of the faculty from the MSc programme in Esthetic Medicine at Queen Mary University London participated in a demonstration of a motorized injection device. Thereafter, they performed a number of injections on a high fidelity silicone simulation model before completing a nine-item questionnaire. The more experienced injectors tended to appreciate the accuracy of the device more than the less experienced participants. Seventy-eight percent of participants said the device improved accuracy, particularly when administering small doses. Eighty-four percent leaned toward a favorable general view of the device. Forty-seven percent would possibly consider purchasing the device. Sixty-one percent would consider recommending the device to a colleague. The main advantage of the motorized injection device was the improved accuracy enabling delivery of small and precise doses. This may open up the possibility of new approaches to botulinum toxin treatments.

Pen devices for self-injection: contrasting measured injection force with users' perceived ease of injection

OBJECTIVES

Past research has emphasized injection force as a clinically highly relevant technical attribute of pen devices. However, little work has been conducted to relate these results to in-use studies. This article explores whether and how differences in pen injection force profiles influence users' self-reported perceived ease of injection and preferences.

METHODS

Three different pen systems were subjected to measurements of injection force using an automated mechanical set-up followed by a simulated use study where users assessed perceived ease of injection.

MAIN OUTCOMES MEASURE

Outcomes were measured by fitting data of measured injection force and perceived ease of injection using a linear model.

RESULTS

Although mechanical testing revealed significant differences between the three pen's measured injection forces these differences were not directly perceived by users in simulated injection studies.

CONCLUSION

The article bridges literature on injection force measurement and simulated use. It reveals how users' perceived ease of injection is less sensitive to measured injection forces than prior research has assumed. Thus, future research should holistically integrate patient feedback in new device development. Key limitations of this work are the low number of participants in the simulated use study and the fact that the ease of injection was assessed indirectly.