Faster pharmacokinetics and increased patient acceptance of intradermal insulin delivery using a single hollow microneedle in children and adolescents with type 1 diabetes

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 adoles...

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Bibliographic Details
Published in:Pediatric diabetes 2013-09, Vol.14 (6), p.459-465
Main Authors: Norman, James J, Brown, Milton R, Raviele, Nicholas A, Prausnitz, Mark R, Felner, Eric I
Format: Article
Language:English
Subjects:
Adolescent
Adolescent Behavior
Attitude to Health
Catheters, Indwelling
Child
Child Behavior
Diabetes Mellitus, Type 1 - blood
Diabetes Mellitus, Type 1 - drug therapy
Diabetes Mellitus, Type 1 - metabolism
Drug Delivery Systems - adverse effects
drug-delivery systems
Female
Georgia
Humans
Hypoglycemic Agents - administration & dosage
Hypoglycemic Agents - blood
Hypoglycemic Agents - pharmacokinetics
Hypoglycemic Agents - therapeutic use
Infusions, Subcutaneous
Injections, Intradermal
insulin
Insulin Infusion Systems - adverse effects
Insulin Lispro - administration & dosage
Insulin Lispro - blood
Insulin Lispro - pharmacokinetics
Insulin Lispro - therapeutic use
Male
Materials Testing
microneedles
Needles
pain
Pain Measurement
pharmacodynamics
pharmacokinetics
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Summary: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. Research design and 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.
ISSN:1399-543X
1399-5448
DOI:10.1111/pedi.12031