It is common for people living with diabetes requiring multiple daily injections of insulin to miss an injection. Now a new technology called a smart insulin pen (SIP) can capture information on how often this occurs. The SIP records the dose and time an insulin injection was given. Although not currently widely available, these new pens will soon become common. In a new study, researchers used a SIP connected to a continuous glucose monitor (CGM) to look at the consequences of missed insulin injections on glucose profiles from a CGM.

Smart insulin pens and glucose profiles

In this study, 64 adults with type 1 and type 2 diabetes taking multiple injections of insulin each day used a new type of SIP with a CGM for 12 weeks. For the first 6 weeks, participants could not see their CGM data (masked period). In the last 6 weeks, they were allowed access to this information (unmasked period). The research took place across 6 centers in the United States.

Missing insulin is common and affects CGM results

Participants missed an average of 22 mealtime insulin injections doses a month during the masked period. This number decreased once they had access to their glucose data in real-time after unmasking. During the unmasked period, glucose levels were improved compared to the masked period, with more time spent between the target range of 70 and 180 mg/dl (from 42% to 49%). From the masked to the unmasked period, glucose levels above and below target improved along with HbA1c levels (from 8.8% to 8.4%). Fear of low glucose levels appeared to be related to missed injections among people with type 2 diabetes, but not for people with type 1 diabetes.

The data from these smart insulin pens may be used as the starting point to uncover factors that affect the number of insulin injections and what happens to glucose levels for insulin-treated individuals.


Photo by Latino Diabetes