Innovative Products to Address the Unique Needs of Patients With Diabetes

MAY 25, 2017
Sponsored by BD.

Patients with diabetes have unique needs—for example, they may take multiple medications, including insulin, and they may be at a higher risk for complications from illnesses, including vaccine-preventable diseases.1 By some estimates, patients with diabetes see a pharmacist 7 times more often than they see a physician; thus, pharmacists have additional opportunities to talk about the use of medications and other appropriate interventions (eg, vaccinations).2,3

Becton Dickinson (BD), a leader in diabetes innovation and care, was the first company to develop and commercialize disposable syringes and short-needle insulin syringes.4 Today, BD continues to address the unique needs of patients with diabetes by developing innovative technologies that improve injection comfort and convenience to help optimize patient outcomes. Over the past several years, BD has demonstrated the efficacy and safety of shorter needles and has introduced technologies that further improve both the comfort and ease of injection.5-8

BD INNOVATIONS TO ADDRESS UNMET NEEDS
Area for Improvement: Accidental Intramuscular Injection
Innovation: BD NanoTM Pen Needles

Use of BD Nano 4 mm pen needles rather than longer pen needles can significantly lower the risk of accidental intramuscular injection. Patients who use BD Nano 4 mm pen needles may be as much as 30 times less likely to accidentally inject medication intramuscularly than patients who use 8 mm needles.9 To optimize injection comfort, BD Nano 4 mm pen needles combine 2 technologies. First, the BD Nano pen needle has a PentaPoint comfort needle tip to reduce injection-site pain.6 Also, BD Nano pen needles have a larger inner diameter, which increases the flow rate of medication by 149% versus competitor 32-gauge pen needles and reduces the thumb force required to administer an injection.8 See SIDEBAR 1 for additional information on needle length and the risk of intramuscular injection.


Area for Improvement: Accidental Needle Sticks
Innovation: BD AutoShield DuoTM Pen Needles
For some patients, including those in hospitals or long-term care facilities or those with caregivers who administer their injections, accidental needle sticks are a primary concern. To address this, the BD AutoShield DuoTM pen needle has patented dual-ended shields to automatically protect both ends after use to ensure the needle cannot be reused and to help prevent accidental needle sticks.11 As the BD AutoShield DuoTM pen needle is 5 mm in length, there is no need to pinch the skin to administer a subcutaneous injection, allowing patients to access and use all injection sites using a one-handed injection technique, thereby promoting injection site rotation.9 See SIDEBAR 2 for more information regarding the importance of injection site rotation.

Area for Improvement: Needle Length and Patient Preference
Innovation: BD Insulin Syringes with the BD Ultra-FineTM Needle

In a 2010 study, more than 80% of patients preferred BD insulin syringes with the BD Ultra-FineTM 6 mm needle to insulin syringes with 8 mm and 12.7 mm needles.14 BD insulin syringes with the BD Ultra-FineTM 6 mm needle are available in 1 mL, 1/2 mL, and 3/10 mL barrel capacities.15 Color coding on packages helps enable selection of appropriately sized syringes, depending on the patient’s specific dose of insulin.15,16

Area for Improvement: Dosing Errors When Using Concentrated Insulin
Innovation: BDTM U-500 Insulin Syringes

In collaboration with Eli Lilly and Company, BD has also innovated in the area of medication safety by developing a specialized U-500 insulin syringe designed to reduce the risk of dosing errors in patients using concentrated insulin.17,18 The BD U-500 insulin syringe can administer up to 250 units of insulin in each 0.5 mL syringe.18 It is important to remind patients that each scale marking on the U-500 insulin syringe scale represents 5 units of insulin.18 Before administering U-500 insulin, patients should note the distinctive green markings of the U-500 insulin syringe and should ensure that they are using U-500 insulin.18 U-500 insulin syringes are available only by prescription, and cannot be sold over the counter.18

BD: A PARTNER TO HELP YOU HELP YOUR PATIENTS WITH DIABETES
Patients who inject diabetes medications are in need of education and support related to the management of diabetes and related conditions. As they see patients with diabetes frequently, pharmacists can offer these patients convenient access to a range of solutions to help optimize management. As a collaborator in patient care, BD provides pharmacists with access to a wide variety of support programs and products, ranging from diabetes drug delivery consultation support, to products for flu and pneumococcal vaccine administration, to point-of-care tests for flu and strep. BD is committed to supporting you and the patients you serve by offering innovative products and services that help improve patient comfort, satisfaction, and overall experience.

REFERENCES
  1. Diabetes type 1 and type 2 and adult vaccination. CDC website. www.cdc.gov/vaccines/adults/rec-vac/health-conditions/diabetes.html. Updated November 1, 2016. Accessed March 14, 2017.
  2. Joslin Communications. More than pill dispensers: how your pharmacist can help your diabetes. Speaking of Diabetes, a Joslin Diabetes Center website. http://blog.joslin.org/2012/04/more-than-pill-dispensers-how-your-pharmacist-can-help-your-diabetes/. Published April 23, 2012. Accessed January 19, 2017.
  3. Wubben DP, Vivian EM. Effects of pharmacist outpatient interventions on adults with diabetes mellitus: a systematic review. Pharmacotherapy. 2008;28(4):421-436. doi: 10.1592/phco.28.4.421.
  4. Fry A. Insulin delivery device technology 2012: where are we after 90 years? J Diabetes Sci Technol. 2012;6(4):947-953.
  5. Frid AH, Kreugel G, Grassi G, et al; Scientific Advisory Board for the Third Injection Technique Workshop. New insulin delivery recommendations. Mayo Clin Proc. 2016;91(9):1231-1255. doi: 10.1016/j.mayocp.2016.06.010.
  6. Hirsch L, Gibney M, Berube J, Manocchio J. Impact of a modified needle tip geometry on penetration force as well as acceptability, preference, and perceived pain in subjects with diabetes. J Diabetes Sci Technol. 2012;6(2):328-335.
  7. Schwartz S, Hassman D, Shelmet J, et al. A multicenter, open-label, randomized, two-period crossover trial comparing glycemic control, satisfaction, and preference achieved with a 31 gauge x 6 mm needle versus a 29 gauge x 12.7 mm needle in obese patients with diabetes mellitus. Clin Ther. 2004;26(10):1663-1678.
  8. Aronson R, Gibney MA, Oza K, Bérubé J, Kassler-Taub K, Hirsch L. Insulin pen needles: effects of extra-thin wall needle technology on preference, confidence, and other patient ratings. Clin Ther. 2013;35(7):923-933. doi: 10.1016/j.clinthera.2013.05.020.
  9. Gibney MA, Arce CH, Byron KJ, Hirsch LJ. Skin and subcutaneous adipose layer thickness in adults with diabetes at sites used for insulin injections: implications for needle length recommendations. Curr Med Res Opin. 2010;26(6):1519-1530. doi:10.1185/03007995.2010.481203.
  10. Vaag A, Handberg A, Lauritzen M, Henriksen JE, Pedersen KD, Beck-Nielsen H. Variation in absorption of NPH insulin due to intramuscular injection. Diabetes Care. 1990;13(1):74-76.
  11. Ruan T, Richards S, Zaiken E, Newman C, Goykhman V, Alu J, Quinn V, inventors; Becton, Dickinson and Company, assignee. Safety pen needle assembly having shielding for patient and non-patient ends. US patent 8,652,503. January 21, 2014. https://docs.google.com/viewer?url=patentimages.storage.googleapis.com/pdfs/US8632503.pdf. Accessed January 19, 2017.
  12. Blanco M, Hernández MT, Strauss KW, Amaya M. Prevalence and risk factors of lipohypertrophy in insulin-injecting patients with diabetes. Diabetes Metab. 2013;39(5):445-453. doi: 10.1016/j.diabet.2013.05.006.
  13. Grassi G, Scuntero P, Trepiccioni R, Marubbi F, Strauss K. Optimizing insulin injection technique and its effect on blood glucose control. J Clin Transl Endocrinol. 2014;1(4):145-150.
  14. Answers and Insights. Insulin syringe test (Project Pearl): Becton Dickinson. September 10, 2010.
  15. BD’s advanced technology makes a difference that you can feel. BD website. www.bd.com/us/diabetes/page.aspx?cat=7002&id=7405. Accessed January 19, 2017.
  16. Insulin syringe size. BD website. www.bd.com/us/diabetes/page.aspx?-cat=7001&id=7252. Accessed January 19, 2017.
  17. Humulin R U-500 (insulin human injection) [package insert]. Indianapolis, IN: Lilly USA, LLC; 2016.
  18. BD receives FDA clearance for new syringe designed for the administration of Humulin R U-500 insulin [news release]. Franklin Lakes, NJ: Becton Dickinson and Company; August 15, 2016. www.bd.com/press/2016/BD-Receives-FDA-Clearancefor-New-Syringe.aspx. Accessed January 19, 2017.



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