Experts in diabetes discuss recent advances in insulin pen technology, including connected and smart pens, and their impact on diabetes care.
Dhiren Patel, PharmD, CDE, BC-ADM, BCACP: Insulin delivery through the pen is probably the most common. Then, we have different delivery mechanisms, such as patch pumps, vials and syringes, and we also have it through insulin pumps, which we’re going to dive deeper into later. However, the more exciting ones that I find of interest are connected insulin pens and smart pens. Diana, can you talk about what you see in the landscape around connected insulin pens, your experience with the ones that we do have, and what excites you regarding the future products that we’re hearing about but aren’t quite here yet?
Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES: Yes. The reality is most people using insulin right now are using insulin pens for vials. In terms of those using insulin pens, most of them are using that kind of standard, what you could even call a legacy insulin pen, something that dials an accurate dose but doesn’t help with calculations or record the dose. When you ask your patient, “How much did you take 2 days ago?” they don’t remember, and you don’t have any log of it. That’s where we now have the smart pens, and this is an area that is going to continue to grow. Like you mentioned, there’s more and more companies that are developing these products. However, this is incredible because it helps people to calculate how much insulin to take. We know that’s hard for people to remember, especially if they have an insulin-to-carbohydrate ratio. Or if they don’t have that, even if we give them a correction factor to add if their glucose is high, that is still hard to remember. Thus, it helps with those calculations, but it also helps the health care team. You know what your patient is taking, so [now] you can better adjust to be able to help them to achieve their glucose targets.
Dhiren Patel, PharmD, CDE, BC-ADM, BCACP: I couldn’t agree more. Dr Busch, I know you have some experience as well and are aware of some of the other ones that are coming between some of the pens and attachments. You’re obviously visualizing a lot of the data that’s currently coming from the continuous glucose monitors [CGMs]. How do you see the connected smart pens? Having that additional data set, how does that affect your day-to-day, and how do you plan on incorporating that into your practice?
Robert Busch, MD: It will be great because of all the other drugs that we have with GLP [glucagonlike peptide] and SGLT-2 [sodium-glucose cotransporter-2 inhibitor]. Not everyone—type 2 diabetics specifically—is on basal bolus therapy because we have so many other good drugs available. The thing I’m excited about is to have the weekly insulin out in the future. Should that get approved, that will be neat. The doses initially scare people because you’re on 7 times the dose, and then there’s a loading dose if you’re transitioning. However, having the smart pens would be a tremendous addition to what we’re having. It’s like a compromise between that and the pump.
Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES: That’s a good point because even though pumps are an option, not everyone wants to be connected to a pump, or the cost is sometimes a barrier, too.
Transcript edited for clarity.