[Injections without needles in the treatment of insulin-dependent diabetes]

Jet injectors, which force a fluid under considerable pressure through a very small opening, have recently become available for subcutaneous administration of insulin. Use of the new devices introduced on the market is neither simpler nor more complicated than use of a syringe. Although jet injectors are highly attractive to both patients and parents, they can be used in only a limited range of diabetics. Main limitations to more widespread use include: 1) the small capacity of the devices which cannot inject more than 20 units of 40 unit/ml insulin; 2) modifications in the pharmacokinetic effects of insulins, especially long-acting insulins; 3) the high price of the injectors. Young children, who often find it difficult to accept injections, may be the main potential target for jet injector therapy. A trial period at home should always be scheduled before considering the purchase of a jet injector.