The use of multiple insulin injection therapy using 'NovoPen' in a routine out-patient setting

Multiple injection therapy using self-contained cartridge devices such as NovoPen has become a standard option for the treatment of insulin-requiring diabetes in recent years. Such treatment was previously viewed as impractical by the majority of patients and their physicians. Many small pilot studies have suggested that the use of such therapy leads to improvements in glycaemic control. We have many (greater than 200) patients in our clinic who use this form of treatment in the context of a routine out-patient department, where intensive supervision, which characterises all studies involving small numbers, is not practical. We have carried out a questionnaire survey of these patients to ascertain their attitudes to this form of therapy, and made some assessment of its impact on glycaemic control. Multiple injection therapy is a very popular form of therapy, leading to improvements in lifestyle and reduction in frequency of hypoglycaemic symptoms. However, its lack of impact on glycaemic control as estimated by measurement of haemoglobin A1 is disappointing.