Fear of Needles
"You feel it a little, but it's nothing" Watch video
For many people with type 2 diabetes, Lantus (insulin glargine), a long-acting insulin approved by the U.S. Food and Drug Administration in 2000, proved to be a boon.
Kathy Davis, 51, a clinical research coordinator in the Toledo, Ohio, area, has been on the once-a-day injection for about a year. "I love it; it's great. My hemoglobin A1C has been 5.9 to 6.2."
In 2002 Mandell switched to Lantus, which covers his basal, or background, insulin needs for 24 hours, eliminating three shots a day. He also upgraded the delivery of insulin with shorter, thinner 31-gauge needles.
"It can sting a little bit sometimes, but certainly it's better than that harpoon I was taking," he says. Mandell also takes Apidra, a rapid-acting insulin, to handle mealtime spikes in blood sugar.
Pre-mixed insulin
Pre-mixed insulins combine an intermediate-acting insulin with one that starts to work more quickly. They're handy for patients because one shot takes care of two different insulin needs. But these concoctions are not as precise as some doctors would like.
At his endocrine practice in North Kansas City, Mo., Richard Hellman, MD, uses very little pre-mixed insulin. People's insulin requirements vary a lot, but the ratios of intermediate and shorter-acting insulin are fixed, he says, "so I feel it's a compromise that has done more for convenience."
Inhaled insulin: off the market
Another innovation, the first inhaled insulin, Exubera, proved not to be very popular. In October 2007 Pfizer said it would stop selling the product. Difficult dosing, a higher cost, and the need for frequent lung-function tests likely damped enthusiasm for this breakthrough treatment.
