New Wearable, Patch-Like Insulin Delivery System for Patients with Type 2 Diabetes

Adult patients with type 2 diabetes requiring insulin therapy can safely achieve good blood sugar control using regular human insulin (RHI) in a wearable, patch-like insulin delivery device called V-Go (Valeritas, Inc), according to a new study presented at the Endocrine Society’s annual meeting, ENDO 2020, in San Francisco, California.

Published in a special supplemental section of the Journal of the Endocrine Society, the study suggests a more affordable option for insulin therapy than new insulin types, according to the researchers.

"The modern insulins—rapid acting insulin (RAI) analogs—have dominated the mealtime insulin market for years, but skyrocketing prices have resulted in concerns of affordability and whether their differences from other available insulins are clinically relevant," said Pablo Mora, MD, lead author and endocrinologist at Dallas Diabetes Research Center at Medical City, Dallas, Texas.

When injected by an insulin pen or syringe, RHI takes longer to reach the bloodstream and has a longer duration of action compared with modern RAIs, according to the study authors. These differences can influence blood glucose control.

V-Go is a 24-hour, small, disposable mechanical device that is cleared for use with RAI in adults with diabetes, is easy to use, and worn like a patch on the skin, according to the study. It is able to deliver both a steady continuous subcutaneous infusion of insulin for 24 hours and mealtime insulin dosing on demand.

The study, conducted at 3 centers in the southern United States, evaluated the safety and efficacy of delivering RHI with V-Go in 113 adults with type 2 diabetes who were using the device filled with RAI. The investigators randomly assigned 54 patients to continue using the V-Go with RAI and assigned another 59 patients to switch the insulin used to fill V-Go from RAI to RHI. Over the 14-week study, the researchers measured the between group difference in average change in hemoglobin A1C, a measure of long-term blood glucose control.

The research team reported that improvements in A1C were observed, with a decrease of 0.6% in the RHI group and a decrease of 0.38% in the RAI group. The study met its primary endpoint of noninferiority, or similar blood glucose control. The researchers found no between-group differences in the total daily dose of insulin required or in episodes of low blood sugar, a measure of safety.

The results support that RHI can be safely and effectively used when delivered by V-Go, according to the researchers.

Reference

• Wearable delivery device allows patients with type 2 diabetes to safely use more affordable insulin option [news release]. Published March 31, 2020. https://www.endocrine.org/news-and-advocacy/news-room/2020/wearable-delivery-device-allows-patients-with-type-2-diabetes. Accessed April 7, 2020.