Pros & Cons of Using Insulin Pens

Insulin and medication pens are very common in the world of diabetes. Pens provide a simple, quick, safe, and discrete way of administering insulin and injectable medication and avoid the multiple and delicate tasks involved in using a standard vial and syringe.  Many pens come in a disposable format which simplifies the process by removing additional steps of refilling the pen. Currently almost all insulins and all injectable diabetes medications come in pens.  This article will provide information on the pros and cons of insulin pens, common characteristics of the pens currently available on the market, how the medication (non-insulin) pens work, and finally considerations regarding the glucagon pen.

 Benefits of Using an Insulin Pen:

• Ease of use by older adults and children as well as those with disabilities, less fine manipulation and complex maneuvering required (good for those with dexterity issues) or vision loss.
• Can provide accurate, finely tuned dosing, using relatively large numbers featured in the dosing window, rather than counting markings on an opaque syringe.
• Portable, convenient, and discreet (can even be given through clothing while seated at a restaurant prior to eating).
• Accurate doses using a dial, especially superior accuracy with smaller doses
• Decreased fear and pain due to smaller, thinner needles.
• Can preset doses using dial.
• Saves time as they are prefilled/preloaded with insulin
• Many are disposable and can be thrown away after use.
• Some have a memory feature that recalls time and amount of dose.
• Easily stored.
• Highly intuitive to use with some requiring little to no instruction.
• Can avoid mixing insulins as premixed are available in pen form.
• Require fewer steps.
• Color coded and differently designed for easily identification.
• Come in newer insulin concentrations which makes dosing easier (syringe and vial would require additional calculations).
• “Smart” pens exist that can calculate appropriate doses of insulin and provide a report on insulin usage for the user to download among other smart features.

Disadvantages

• Can only be used for self-injection.
• Usually, higher cost than syringe and vial.
• Lack of universal coverage by some insurances.
• Requires a separate pen needle tip.
• Can be easily lost.
• May require a second shot if insulin in pen is insufficient.

Insulin Pens

In 2018, Diabetes Care reported that a slight majority of the 7.4 million Americans on insulin chose vials and syringes to inject insulin.  The Health Care Cost Institute went further to state that vials made up 53 percent usage while prefilled insulin pens were used by 46 percent.  Reusable pens with cartridges made up less than 1 percent annually.  An additional study published in the Journal of Clinical Medicine in January 2016 estimated that 350,000 Americans used an insulin pump. Unlike the U.S., pens are widely used by Europeans with percent use at 80% according to a review published by The International Journal of Pharmaceutical Investigation in their January to March 2016 issue.

Different pens are compatible with different types of insulin. Some can hold larger doses.  Some pens provide 1-unit increments, others ½ unit. Some have added features like the pairing with a smartphone to calculate insulin doses among other attributes. The chart below identifies the company, the pen(s) it makes, the name of the insulin, the total insulin capacity of the pen, whether it is disposable or refillable, and lastly, features.  When selecting an insulin and pen type, and for precise dosing, seek the advice of your physician or diabetes educator.

Insulin Pens

Currently the only medication/insulin combination pen is Soliqua.

Medications

The injectable medications have many functions and work on the pancreas, liver, stomach, and intestine all with the goal of normalizing blood glucose levels in the body. The chart below identifies each injectable medication, it’s function(s), and how often it is taken.  For precise dosing seek the advice of your physician or diabetes educator.  Side effects can be viewed on the prescription insert or can be ascertained through your diabetes care team including your pharmacist.

Medication Pens