Insulin Insights

Challenges and Solutions for Precision Insulin Management

As providers of health care, you know the challenges people experience living with diabetes, especially when dependent on insulin. Despite the life-saving benefit of exogenous insulin, getting the right dose administered at the right time may seem an impossible task. Technology can help. Janice Macleod, MA, RD, CDCES, FADCES and Robert Vigersky, MD have summarized in their recent article how connected insulin pens can help ease the burden of knowing how much and when to dose insulin.¹

Challenges associated with insulin use include mismatched/missed/mis-timed doses, not having historical reports on dosing behavior to help adjust doses and insulin damaged by temperature extremes. Insulin pump therapy can address many of these challenges. However, not all people needing multiple daily injections (MDI) of insulin are ready for insulin pump therapy. If they are new to technology, there is an easy way to start moving beyond insulin syringe and disposable pens. Connected insulin pens offer a variety of features that can help ease some of the challenges of insulin management. More connected devices are becoming available in the marketplace, including tracking insulin pens, smart insulin pens, and smart caps.¹  

The Medtronic InPen^TM smart insulin pen, designed for mealtime insulin, can deliver precise dosing in ½ unit increments. The right dose is determined with the phone app calculator by using individually prescribed settings for a regimen of fixed meal dose, meal estimation dose or carbohydrate counting. Reminders can be set on the app to send an alert if a mealtime dose was missed and when long-acting insulin is due. All InPen^TM injections are automatically recorded for immediate review on the app or later review in a generated report that can be shared through the app with the patient’s care team. App alerts occur if the temperature of InPen^TM reaches certain high or low thresholds, warning the user of possible insulin damage.

For those individuals who are using continuous glucose monitoring (CGM), the glucose data generated by Medtronic Guardian^TM Connect or by another continuous glucose monitor can be combined into a single report from the InPen^TM app. Utilizing data from the combined reports can help the care team make therapy adjustments.

When helping your patients get started with connected insulin pens, don’t forget the basics of insulin managment:¹

• Check patient’s understanding of site rotation, timing of insulin dose, priming, safe insulin storage
• Assess insulin injection technique and assess body sites used for insulin injection
• Optimize the long-acting insulin dose and identify when to add prandial insulin in type 2 diabetes (T2D)
• Establish and periodically adjust rapid-acting insulin calculator settings
• Prescribe and train on the use of CGM per standards of care

Refer to medtronicdiabetes.com for more information or contact your local Medtronic Diabetes representative. 

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Important safety information: InPen™
The InPen requires a prescription. It is a home-use reusable pen injector for single-patient use by people with diabetes under the supervision of an adult caregiver, or by a patient age 7 and older for the self-injection of a desired dose of insulin. The pen injector is compatible with Lilly Humalog® U-100 3.0 mL cartridges, Novo Nordisk Novolog® U-100 3.0 mL cartridges, and Novo Nordisk Fiasp® U-100 3.0 mL cartridges and single-use detachable and disposable pen needles (not included). The pen injector allows the user to dial the desired dose from 0.5 to 30 units in one-half (1/2) unit increments.

The InPen dose calculator, a component of the InPen app, is indicated for the management of diabetes by people with diabetes under the supervision of an adult caregiver, or by a patient age 7 and older for calculating an insulin dose or carbohydrate intake based on user entered data.

For an insulin dose based on amount of carbohydrates, a healthcare professional must provide patient-specific target blood glucose, insulin-to-carbohydrate ratio, and insulin sensitivity parameters to be programmed into the software prior to use.

For an insulin dose based on fixed/variable meal sizes, a healthcare professional must provide patient-specific fixed doses/meal sizes to be programmed into the software prior to use.

For additional product and important safety considerations, see User Guide and http://bit.ly/InPenSafety

Important safety information: CGM/Guardian™ Connect system
The Guardian™ Connect system requires a prescription and is indicated for continuous or periodic monitoring of glucose levels in the interstitial fluid under the skin, in patients (14 to 75 years of age) with diabetes mellitus. The system is intended to complement, not replace, information obtained from standard blood glucose monitoring devices, and is not recommended for people who are unwilling or unable to perform a minimum of two meter blood glucose tests per day, or for people who are unable or unwilling to maintain contact with their healthcare professional. The system requires a functioning mobile electronic device with correct settings in place for accurate operation. A non-functioning mobile device or incorrect settings may prevent the app from issuing alerts. Missing alerts may result in undetected low and high glucose levels. For complete details of the system and its components, including warnings, contraindications, and precautions, please consult the user guide at http://www.medtronicdiabetes.com/support/download-library/user-guides and www.medtronicdiabetes.com/importantsafetyinformation.

Important safety information
Medtronic Diabetes insulin infusion pumps, continuous glucose monitoring systems and associated components are limited to sale by or on the order of a physician and should only be used under the direction of a healthcare professional familiar with the risks associated with the use of these systems. Successful operation of the insulin infusion pumps and/or continuous glucose monitoring systems requires adequate vision and hearing to recognize alerts and alarms.