Recently, there have been significant technological advancements in insulin delivery. They are set to revolutionize the way we combat diabetes. With cutting-edge technologies at our disposal, we can revamp our daily routines.
According to 2020 statistics, over 30 million Americans have diabetes. More than 15% of those affected are using insulin therapy. For a type 1 diabetic, such as myself, insulin is the mainstay of treatment.
Since insulin was first discovered in 1921, scientists have tirelessly worked to develop various insulin analogs and innovative formulations.
In recent years, they’ve made remarkable progress. They’ve introduced ultra-rapid-acting insulin and ultra-long-acting basal insulin treatments.
Here, I want to discuss the ongoing innovations in insulin therapy. What can you expect from these devices, and how can they change the diabetes treatment you use today?
What improvements have been made to insulin?
Insulin delivery systems are getting more advanced. From simple patches to smart insulin pens, they can provide tailored treatment that helps minimize the risk of diabetes complications and make insulin administration more comfortable.
One of the most notable advances is the development of closed-loop systems. These systems automatically fine-tune insulin delivery in real-time. They mirror the body's natural functions by responding to sensor glucose levels.
Closed-loop systems use different algorithms that enable precise adjustments to maintain optimal blood sugar levels. These new insulin delivery systems are designed to reduce the burden of the disease and boost the quality of life.
Wearable Insulin Patch
The latest insulin administration device is the wearable patch. I’m using the CeQur Simplicity, which offers injection-free insulin for mealtime. It is the lightest and thinnest patch on the market.
Compared to traditional insulin injections, the patch uses a soft cannula. It works similarly to other transdermal patches, like muscle pain relief patches or nicotine patches. It delivers insulin through the skin, minimizing discomfort.
Smart Insulin Pen
The smart insulin pen is an exciting recent innovation for anyone with diabetes. I tried using the NovoPen® when it came out. The pen allows for more accurate, simple, and convenient delivery than using a syringe and a vial. This device can make life easier for those who need multiple injections a day.
Smart pens show when I miss a dose, how much insulin I’ve taken, and when was the last time I took it. Plus, I can pair it with apps that provide data from blood sugar meters and CGM. So, I can store all my insulin and blood sugar data in a single place.
Hybrid Closed Loop (HCL) is Effective for Youth and Adults
Hybrid Closed Loop (HCL), also known as automated insulin delivery or artificial pancreas, is a recent delivery system. It can automatically decrease or increase basal insulin delivery. It uses an algorithm and real-time sensor glucose trends from a CGM device.
The HCL is an insulin pump that improves blood glucose control. The HCL program calculates the appropriate basal insulin dose every 5 minutes. It adjusts insulin delivery up or down based on your sensor glucose (SG) levels.
But it still requires the user's active participation. I still need to manually administer bolus insulin for my meals, just like with a regular insulin pump.
According to 2023 trials, an artificial pancreas has effectively improved blood sugar control in adults and children with type 1 diabetes. During the 13-week study, researchers examined children aged 2 to 6 years old with type 1 diabetes.
The goal was to compare the effectiveness of a hybrid closed-loop system against the standard-care insulin delivery method. This included the use of a continuous glucose monitor (CGM). The results revealed that the hybrid closed-loop system spent a higher percentage of time within the target glucose range than standard-care insulin delivery.
The Future of Once-a-Week Insulin
Currently, two pharmaceutical firms are developing a basal insulin formulation that requires only a once-a-week administration. Novonordisk's Icodec insulin, for example, has shown some promising results in studies for treating type 2 diabetes.
In 2022, Novonordisk published some of the most recent data. In the ONWARDS 5 phase 3a trial, once-weekly insulin icodec, when used alongside a dosage guidance application, exhibited a remarkable reduction in HbA1c levels compared to once-daily basal insulin in type 2 diabetic patients.
Research in type 1 diabetes is still ongoing.
What is the newest insulin delivery system?
On May 19, 2023, the FDA cleared the iLet ACE Pump and the iLet Dosing Decision Software for patients 6 years or older with type 1 diabetes.
These two devices, when paired with an FDA-approved integrated continuous glucose monitor (iCGM), will form a new system called the iLet Bionic Pancreas. It uses a specialized algorithm to calculate and regulate insulin administration.
The iLet is a pocket-sized device and is available for both adults and children.
Unlike other artificial pancreas systems, the iLet sets itself apart by requiring minimal user input. It operates through a closed-loop mechanism. The device automatically administers insulin based on my body weight, without me having to make manual adjustments.
During mealtimes, the iLet employs a "meal announcement" feature that eliminates the necessity for precise carbohydrate counting. Instead, you can estimate how many carbs to eat and enter it as "small," "medium," or "large" into the device.
The iLet's algorithm adapts to my specific insulin requirements, independently determining and delivering the appropriate doses. Additionally, it can adjust the basal insulin rate (background insulin) by increasing, decreasing, maintaining, or suspending the rate as needed.
