Metabolic control and patient acceptability of multiple insulin injections using NovoPen cartridge‐packed insulin

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Abstract
A packed syringe ‘NovoPen’™ loaded with a prefilled cartridge containing soluble insulin (Actrapid HM), was evaluated in a multiple‐dose injection regimen by 20 patients with insulin‐dependent diabetes mellitus (IDD). Following an induction period of 8 weeks with self‐monitoring of blood glucose, the patients changed for the next 24 weeks to three preprandial soluble insulin injections per day using a NovoPen with an evening injection of human protaphane insulin. A questionnaire completed before the study revealed that a rigorous daily schedule for meals and activity was the single most important disadvantage of the diabetic life (47% of the patients). At the end of the study, only 21% and 10% respectively still considered these problems to be inconvenient. All patients showed greater ability to vary the time of meals, and all but one wanted to continue multiple injections with NovoPen.Blood glucose and HbAlc did not improve in the multiple injection period, whereas blood glucose oscillations fell from 3.0 mmol/1 (1.0–6.0) to 1.7 mmol/1 (0.9–4.6) (p < 0.01), and the frequency of subjective hypoglycaemia was reduced from 1.2 attacks/patient/week (0–5.5) to 0.3 attacks/patient/week (0–2.1) (p < 0.01). There were no technical problems with insulin administration with NovoPen and no complications (serious hypoglycaemia, ketoacidosis or local reactions at injection sites). Thus, multiple insulin injections with NovoPen were well accepted by the patients and resulted in improvement of some parameters of glycaemic control.

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