Choosing the Right Insulin Delivery Solution: Comparing Smart Pens vs. Needle-Free Injections (2024)

When it comes to diabetes management, finding the right insulin delivery solution can be challenging right after you’re diagnosed.

Insulin pumps can be intimidating to new patients because they require constant blood glucose monitoring to function with limited side effects.

Aside from the waning interest in using traditional methods like syringes, an insulin pen can feel like an outdated solution, as it also uses a needle to inject insulin. That explains the shift toward smart insulin pens, which help patients control insulin doses and better manage their condition.

As for needle-free jet injectors, they’re less painful insulin delivery devices for people with diabetes who struggle with needle phobia.

Here’s a thorough breakdown of smart pens vs. needle-free injections if you’re still trying to decide the right insulin delivery solution.

A smart pen is a reusable technological device used to administer insulin injections. It connects with a smartphone application, which can help the diabetes patient calculate accurate dosing. This pen also provides reminders and alerts and creates reports about insulin injection times and doses.

Some smart insulin pens can detect the quality of the insulin cartridges, whether they have expired or gotten too hot. They can also send health-related data to your healthcare team if need be.

• Novo Nordisk NovoPen® 6 and NovoPen Echo® Plus
• Medtronic InPen™

Using smart pens can make a difference in the patient’s insulin management regimen. That said, there are advantages and disadvantages to taking insulin that way. We’ll break them down in detail here.

Smart pens are high-tech devices that connect to your smartphone via Bluetooth. That’s why most companies create them to be reusable.

Using a reusable insulin pen with a replaceable cartridge and insulin pen needles reduces plastic waste and is a more sustainable way to deliver insulin injections.

Compatible smartphone apps have some great features, the most important of which is dose-tracking.

Instead of relying on external reminders and being at risk of insulin stacking (in case you forget you already took your dose and take another one), the smart pen can let you know how many units you injected and remind you when it’s time for your next dose.

Some smart insulin pen apps also have carbohydrate trackers and insulin dose calculators, which should help you take as much insulin as you need. This is great because it minimizes the chance of blood glucose fluctuations should you inject too much or too little insulin for the carbs you consume.

Insulin pens and smart pens can last you for about a year without worrying about changing the battery. They’re better than insulin pumps, which require frequent maintenance and can put you at risk of high blood glucose (and even ketoacidosis) if they malfunction.

If you don’t have adequate healthcare insurance coverage, using a smart pen can be too financially taxing. Considering that most pens also require specific insulin cartridges your insurance might not cover, choosing an insulin pen option that fits your situation can get tricky.

Some people with diabetes can struggle to understand and implement the steps to use smart insulin pens. This can be due to age, disability, or comfort with their current insulin delivery system and the lack of desire to change it.

Smart pens are still “traditional” insulin pens that use a needle to inject insulin into the fat layer under the skin.

While some veteran insulin users have no problems with that, others suffering from needle phobia or discomfort at the injection site might have issues with it. This can be especially prevalent in newly diagnosed cases.

A needle-free insulin injector is a device similar to traditional insulin pens in that it’s used for multiple daily injections. However, instead of regular insulin pen needles, it has a jet injection mechanism that delivers the insulin to the subcutaneous tissue.

Unlike a regular insulin pen, which usually has a short-to-medium needle that injects insulin into one spot, the device is loaded with a prefilled insulin cartridge fitted with an adaptor. It then connects to a spring-operated, batteryless mechanism that injects the insulin at high speed to spread over a larger area of the fat layer under the skin.

This allows the insulin to be absorbed more slowly and evenly, avoid intramuscular injections, and help control blood glucose for a longer period without using a higher dose.

• InsuJet Needle-Free Jet Injector

Needle-free injectors have been on the market for quite some time now, which makes their advantages and disadvantages clearer based on user experience. Here’s what to consider before choosing a needle-free insulin injection device.

Needle-free injectors are quite intuitive to use thanks to their larger size and easier mechanical controls than regular insulin pens. For the InsuJet, a dose is determined by turning the cap to one side to increase the dose units and vice versa to decrease them.

This is especially great for patients who struggle with finer controls, although it’s advised for patients with motor or visual disabilities to be supervised when taking their insulin.

Another great aspect of needle-free injection is that it produces no medical waste since the disposable nozzle attachments have no needle-sharp, unlike a traditional insulin pen needle.

There’s also the added bonus of reducing the number of needle-stick injuries the patients and healthcare personnel face when using the needle-free injector.

For patients who need multiple daily insulin injections, pen injections can get uncomfortable or even painful when they use the same injection site or an unsuitable injection technique.

Most patients ' discomfort and pain are reduced because needle-free injectors don’t have regular pen needles. The InsuJet V5 also has a comfort ring, which dampens the effect of the injection, making for a softer point of impact on the injection site.

The mechanism with which the needle-free jet injector works also helps regular insulin perform better in the case of type 2 diabetes patients. According to this study, it even works similarly to insulin Aspart, a highly effective insulin analog.

Needle phobia is a real condition some people suffer from, where they get anxiety symptoms when a needle is used around them.

Unfortunately, for a person living with diabetes who requires multiple insulin injections per day to maintain glycemic control, this condition could prove extremely dangerous if it affects how well they adhere to their treatment plan.

A study found that patients who suffer from needle phobia had a marked improvement in compliance with their insulin regimen when they used a needle-free injector.

Depending on your location and insurance coverage, you should invest in the needle-free injection device and its accessories upfront. This can be too high of a commitment to some patients.

That said, the break-even point for the InsuJet, compared to using a syringe and vials, is about 11 months after purchase. The device can serve the patient for over 5600 injections, or about three years of daily use.

Some patients find learning to use a new device challenging and even impossible. This is especially true if it requires switching from a short-and-long-acting insulin mixture to premixed insulin.

Using a new method to adjust the doses, like the turning cap, could lead to inaccurate dosing, which could cause hyper or hypoglycemia, depending on the discrepancy.

People with diabetes who are visually impaired or have motor issues that make them unable to handle the injector properly are contraindicated to use needle-free injection as a method of insulin delivery. The same goes for those who have skin issues like psoriasis or are on anti-bleeding medications.

Children younger than ten can also struggle to handle the injector, so it’s best to have a caretaker administer the insulin instead.

Now that you’ve reviewed the pros and cons of smart insulin pens and needle-free injectors, you can make a better-informed decision regarding which method should work for your condition. You can decide based on:

Most health insurance plans cover regular insulin pens as a treatment for diabetes. Some companies will take longer to approve a more expensive option, like smart pens or needle-free injectors, unless your physician advocates for you.

Talk about your condition with your healthcare team. Ask for their recommendation before contacting your insurance provider with a formal request or complaint.

Adapting to technological advances when it comes to healthcare, especially if you’re a long-time diabetes patient, can vary among different people. If you find yourself more inclined to use an “offline” insulin injection option, then a regular insulin pen or a needle-free injector could be more suitable than a smart pen.

On the other hand, if using technology to monitor your glucose levels and improve dosing accuracy sounds interesting, then a smart pen could be a good decision.

If needle phobia stands in the way of adhering to your insulin regimen and controlling your blood glucose, then choose a needle-free jet injector.

If you use it with a continuous glucose monitor (CGM), you can get similar results to a smart pen without all the extra discomfort, anxiety, or pain.

With all the new technologies in insulin self-administration, countless options are reaching the market, making diabetes management a little easier and less uncomfortable.

Comparing smart pens and needle-free injections gives us a better understanding of what patients find valuable in their diabetes treatment journey.

Some patients would prefer a bird’s eye view of their stats and numbers, even if it comes with a little discomfort during injection. Others prefer a comfortable injection method, even if using other devices, like a CGM, is necessary.

It all depends on the patient’s treatment goals and desire to achieve them.