Diabetes patients get their insulin in a variety of ways. Options include multiple daily injections and insulin pumps. Each of these methods involves a needle stick. New insulin delivery methods promise needle-free insulin delivery.
There’s an appealing new way of delivering insulin that’s in the stages of early research – insulin patches. The patch promises to deliver insulin through the skin similar to nicotine patches or patches for pain relief. The insulin would be delivered needle-free.
If successful, they would offer opportunities for people on insulin therapy to take it without needing to put needles or infusion sets into the body.
How Would The Insulin Patch Work?
Each patch would contain a set dose of insulin that is absorbed slowly through the skin. The insulin travels into the blood stream over a number of hours. Some of the insulin patches were developed to release insulin quickly. This feature addresses spikes in blood sugar following food intake (bolus insulin patches). Other patches have been developed to counterbalance the progressive release of glucose over the course of the day by the liver (basal insulin patches).
Technology Challenges in Insulin Patch Development
In order for insulin to pass through the skin in a controlled and consistent way, insulin patches require additional agents be added. These agents help prevent blood glucose levels from going too high or too low. A number of manufacturers are developing insulin patch options and conducting clinical trials. Early results are promising as being a feasible form of future treatment.
Inhaled Insulin – Another Delivery Method
Another another alternative insulin delivery method is inhaled insulin. The FDA approved inhaled insulin in 2014. Use by patients under the age of 18 is still not approved. Inhaled insulin can be used to manage both type 1 and type 2 diabetes. The insulin is in a powder format that is quickly absorbed after you inhale.
Some patients use inhaled insulin along with traditional injections. This regimen offers convenience and helps blood sugar management after eating and throughout their day. Additional versions of inhaled insulin are in development from a number of manufacturers.
Smart Insulin Patch Development
Insulin basics from the American Diabetes Association
The 411 on CGM
The medical device market is always advancing technologically, as with most other industries. One new technological development, the Continuous Glucose Monitor (CGM), provides added peace of mind to diabetics by providing 24-7 information about blood sugar levels. This constant feedback provided by the device allows for better short and long term control of your diabetes, which will also improve your A1C levels.
The device is comfortable to wear and decreases the number of finger pricks you need to perform daily to check blood sugar. Patients who use a CGM often only need to test their blood sugar twice per day. Two finger pricks per day is much better than the typical number of ten times! This is a huge step forward in diabetes management.
A CGM system includes three components: a sensor, transmitter, and receiver. The sensor inserts into your skin and uses the same enzyme as a test strip (glucose oxidase) to measure blood glucose. The glucose oxidase in the sensor converts the glucose in your blood to hydrogen peroxide, which reacts with the platinum in the sensor. This reaction sends a signal to the transmitter, which inserts into the sensor. The transmitter then communicates with the receiver (or other connected device), notifying you via alerts if your blood sugar is trending high or low. Sensors need to be replaced every seven days.
Here at Active Healthcare, we have a number of patients benefiting from CGM. Our patients appreciate the ability to analyze their blood glucose results and adjust their basal levels accordingly instead of guesstimating from multiple manual tests. We offer two Dexcom systems, the G4 Share and the G5. The G5 is Dexcom’s newest model and pairs with a smartphone or any Apple device, eliminating the need to carry your receiver around. This is especially good for patients who already carry a lot of supplies and devices around to manage their diabetes, such as students. Both systems enable the patient to share device information with up to five other people. We also provide the ongoing supplies for our CGM patients and can send these in the same shipment as your regular diabetic supplies.
Integration with Insulin Pumps
Many insulin pumps are now integrated with CGM including the Animas Vibe and Tandem G4. The newest Tandem pump, the t-slim X2, will have compatibility with this feature later this year. Because the CGM is a complex device, it is recommended that patients get as much information and training as possible both from their physician, diabetic educator, and the various manufacturers before beginning its use.
If you have Type 1 diabetes, your entire day can be spent treating your condition. Over the past few decades, technology has advanced significantly, making life as a Type 1 diabetic easier than ever before. The FDA approval of a new medical device called the artificial pancreas in September 2016 will continue this trend. Derek Rapp, President and CEO for the Juvenile Diabetes Research Foundation (JDRF) says that the artificial pancreas “is a historical achievement for JDRF and the entire T1D community. After years of laying the ground work, this life-changing breakthrough is a true testament to the reason JDRF exists, which is to accelerate ways to cure, prevent, and treat this disease.”
Smart Phones and Diabetes Control: Mimicking the Pancreas
Researchers at the University of Virginia are developing and testing these devices. This device has two components: a smartphone and an implanted insulin pump. You may be asking yourself, but how does it work? The smartphone component uses an algorithm to deliver just the right amount of insulin into the body, as well as control blood levels. The insulin pump receives the patient’s blood sugar levels from the smartphone every five minutes in a process called “looping.” The device performs the same functions as a healthy pancreas.
Clinical Trials for Closed Loop Systems
Trials are being conducted all over the United States and Europe, the first of which is the International Diabetes Closed-Loop trial. This trial will be performed using the device developed by UVA and will be led by Boris Kovatchev, director of the UVA Center of Diabetes Technology. According to Kovatchev, the artificial pancreas is “not a single-function device; it is an adaptable, wearable network surrounding the patient in a digital treatment ecosystem.”
Les Hazelton, a 59 year old type 1 diabetic from Minnetonka, Minnesota, says that until he enrolled in a trial at Park Nicollet’s International Diabetes Center in Minneapolis, he was always chasing his blood sugar. “It was totally mind-blowing. I like being in better control of my body and my disease. The more I know about what’s happening right now, the better I can manage it,” he said.
You are likely wondering when such a device will be available on the market. Diabetes In Control www.diabetesincontrol.com says that with several trials having been conducted in 2016, we could see the first artificial pancreas available sometime this year.
Smartphone Apps to Track Health
With the advent of apps for smartphones, there’s something nostalgic about using a pen and paper. At meetings, I often find myself still jotting down action items in a notebook instead of in my iPad. But, when it comes to tracking my health, I’m grateful to have so many intuitive and user-friendly apps at my disposal. I can track my sleep habits, exercise and diet easily with my smartphone. There are also a number of useful health tracking apps available for individuals with specific conditions like asthma and diabetes.
Diabetes App Roundup
Here’s a roundup of some of the best diabetes apps available:
- Diabetes Logbook: This free app is available on the iPhone and Android platforms; Diabetes Logbook is a personalized way to track meals, blood sugar, carbs and more. The app manages to be both entertaining and educational, making users more motivated to consistently manage their diabetes.
- OnTrack Diabetes: A simple, intuitive design makes this app user-friendly. Available for free for Android users, OnTrack Diabetes is a way to log medication use, glucose levels, weight, exercises and more. Tables and graphs can easily be shared with doctors.
- Carb Counting with Lenny: This app’s colorful design and built-in mascot, Lenny the Lion, encourages children with diabetes to get in the habit of carb counting. The app also includes educational games that help boost kids’ confidence in better managing their diabetes. This app is free and available to iPhone users.
- Diabetik: Individuals with type 1 or type 2 diabetes can easily monitor meal frequency, blood glucose levels, and medication intake via interactive charts with the free iPhone Diabetik app.
- HealthyOut: This free app makes eating out easier by providing users with the ability to search for local restaurants that offer more diabetic-friendly meals. Users can search based on filters like “Low Carb” or Low Fat” to find healthy options while eating out.
Thanks to colorful designs, interactive charts, and user-friendly features, these apps streamline diabetes management in intuitive ways. App users can often share key data with doctors and have confidence in experiencing greater control over managing their condition.
Image courtesy of Bloom.
I bet I’m not alone in the constant battle to limit the amount of stuff I carry around during the day. With oversized purses in fashion, it’s easy to want to fill up the space in my bag with everything but the kitchen sink. There are so many essentials—medication, hand sanitizer, tissues, lip balm, mints—that add up to a very heavy bag. It’s hard to determine which items I could probably do without. I mean, they’re called essentials for a reason, right? Fortunately, some essentials are getting smaller. The Bloom inhaler—a thin, credit-card sized inhaler for asthmatics—is currently under development. The Bloom inhaler fits neatly into the credit card slot in a wallet, which makes it easy to carry, and simple to access.
How it Works
Users load medication from their typical inhaler canister into the Bloom cartridge that holds up to six doses of medication. Bloom is leak-proof and pressing the device’s trigger dispenses a precise dosage. Medication from any HFA inhaler can be used in Bloom and the device can be refilled over and over. Bloom doesn’t use a mouthpiece, but instead uses the “Open Mouth Technique” which the company likens to “using a breath spray.”
Image courtesy of Bloom.
The Bloom inhaler creators expect the FDA to approve the device by November 2016, but interested customers can reserve one of the inhalers ahead of time by going to the company’s website. Each Bloom device will cost $40. If this device is approved, it could free up some room in my bag for other essentials…not that I need a reason to make my purse any heavier than it already is!
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Children’s Lives Saved by 3-D Printer Technology
Tattoos aren’t just a fashion statement anymore—nanoengineers have developed a temporary tattoo that can test blood sugar levels. This technology is promising for diabetics since their current option for testing blood sugar levels is by taking fingertip pricks several times a day. Using a temporary tattoo instead would be a much more comfortable and convenient way to test blood sugar levels.
Amay Bandodkar, graduate student and colleagues in Professor Joseph Wang’s laboratory at the NanoEngineering Department and Center for Wearable Sensors at the Jacobs School of Engineering at the University of California, San Diego, developed the sensors in the temporary tattoo. The sensors emit a mild electrical current that measures glucose levels. The electrodes are printed on tattoo paper that gives the user a painless way to test their blood sugar. The tattoos last a day and only cost a few cents.
A closer look at the temporary tattoo that measures glucose levels.
The tattoo was tested on seven healthy male patients that do not have diabetes. Although the tattoo recorded a change in their glucose levels, scientists had to remove the tattoo in order to collect data because it doesn’t currently provide the patient with a way to read or monitor their own glucose level. In the future, the tattoos will connect with Bluetooth so data collected by the tattoo can be transmitted to the patient’s doctor or stored in the cloud. The technology used in the tattoo could eventually be used for other medical purposes, like delivering medicine or identifying important metabolites.
Photo credit: Jacobs School of Engineering/UC San Diego