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

Pediatr Diabetes. 2013 Sep;14(6):459-65. doi: 10.1111/pedi.12031. Epub 2013 Mar 21.

Abstract

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.

Trial registration: ClinicalTrials.gov NCT00837512.

Keywords: drug-delivery systems; insulin; microneedles; pain; pharmacodynamics; pharmacokinetics.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • 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*
  • Female
  • Georgia
  • Humans
  • Hypoglycemic Agents / administration & dosage*
  • Hypoglycemic Agents / blood
  • Hypoglycemic Agents / pharmacokinetics
  • Hypoglycemic Agents / therapeutic use
  • Infusions, Subcutaneous
  • Injections, Intradermal
  • Insulin Infusion Systems / adverse effects
  • Insulin Lispro / administration & dosage*
  • Insulin Lispro / blood
  • Insulin Lispro / pharmacokinetics
  • Insulin Lispro / therapeutic use
  • Male
  • Materials Testing
  • Needles
  • Pain Measurement

Substances

  • Hypoglycemic Agents
  • Insulin Lispro

Associated data

  • ClinicalTrials.gov/NCT00837512