Addressing barriers to insulin therapy: the role of insulin pens

Am J Ther. 2011 Sep;18(5):392-402. doi: 10.1097/MJT.0b013e3181ef4dde.


Despite the fundamental role of insulin therapy in diabetes management, many patients and some clinicians may resist insulin initiation due to concerns about its complexity or a general resistance to injections. Many patients' concerns about insulin initiation may stem from perceptions about the pain and inconvenience of using vials and syringes for delivering insulin. However, insulin pen devices offer an easier method for insulin administration that is more accurate, less painful, and more discreet compared with vials and syringes. Advances in insulin pen technology have enhanced their utility by increasing their accuracy, reducing the injection force required, and incorporating mechanisms to store the dose, time, and date of previous insulin injections. Substantial evidence demonstrates that insulin pen devices are preferred by both patients and clinicians and have the potential to improve adherence, enhance quality of life, reduce the risk of hyperglycemia, and decrease costs. Ultimately, the advantages of insulin pens may reduce resistance to initiating and adhering to insulin therapy. Because insulin pens are underused in the United states compared with in other countries, it is critical that clinicians understand the potential benefits of insulin pens and communicate them to their patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 2 / drug therapy
  • Drug Costs
  • Drug Delivery Systems*
  • Humans
  • Hyperglycemia / chemically induced
  • Hypoglycemic Agents / administration & dosage*
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / economics
  • Insulin / administration & dosage*
  • Insulin / adverse effects
  • Insulin / economics
  • Medication Adherence
  • Patient Preference
  • Quality of Life
  • United States


  • Hypoglycemic Agents
  • Insulin