Does the use of an insulin pen device rather than a vial or syringe help older adults

manage their diabetes more effectively in the community?

Introduction
Every major research study to date has shown that individuals with diabetes benefit greatly
from keeping their sugar levels under control, as measured by their haplotype A1c (HbA1c)
(Miao et al., 2014). Glycemic control is the sole method for most individuals to prevent or
greatly lessen the severity of these repercussions because the ongoing disease is
degenerative type 2 diabetes. Traditional methods of administering insulin involved painful
vials and syringes with bigger bore needles. However, in 2008, this is not the case, despite
the widespread belief among patients with diabetes that these needles are still huge and
unpleasant.

Using pen gadgets makes a lot of sense for a variety of reasons. Patients are more likely to
take their medication as prescribed when using a pen device instead of a syringe since it is
more convenient to transport and use (Bahendeka et al., 2019). Using an injecting device
makes taking insulin less of a public spectacle and cuts down on the expense of managing
diabetes. Although the use of pens is on the rise among people with diabetes, the United
Kingdom ranks last among industrialised countries.

Problem Statement
One of the factors that contribute to the onset of type 2 diabetes mellitus is getting older
(T2DM). In the United Kingdom, adults over the age of 65 have diabetes at a rate 26.9
percentage points higher than the overall population (8.3 percentage points). (Miao et al.,
2014) In 2004, a cross-sectional assessment of UK people receiving home care confirmed
that about a quarter of individuals aged 65 and up residing in nursing institutions had
hyperglycemia as their original entrance and/or procedure versions (Bahendeka et al.,
2019). Diabetes is a leading cause of healthcare expenditures, accounting for 30% to 40% of
all surgeries and 30% to 60% of all skilled nursing hospitalizations among individuals aged
65 to 74%. Amongst some of the elderly, hyperglycemia is expected to increase in
prevalence and difficulty of treatment as the world's population ages (Ramadan et al., 2015).

There is a special set of challenges associated with caring for elderly people who have type
2 diabetes. To begin with, people in this group have a greater threat of dying from
complications related to diabetes, such as heart disease, chronic pain, and psychological
distress (Valencia et al., 2019). The argument is that prophylactic antibiotics need to be
administered and evaluated with more caution when it comes to the elderly and there could
be fewer treatment choices for hyperglycemia throughout this demographic (Ramadan et al.,
2015). Although the patient's health may play a role in therapy selection, accounting for 72
(defined by the number of recurrent ailments or impairment of exercise capacity) will also be
factored into the equation (Valencia et al., 2019). It is alarming because approximate 36.7%
of older persons with T2DM in the United Kingdom suffer from nephritis, although metformin
is typically inappropriate due to glomerulonephritis or severe cardiac failure. Furthermore,
elderly people with T2DM seem to be more likely to experience hyperglycemia and
accompanying complications, such as confusion and falls. You should stay away from
chlorpropamide and gliclazide since they can cause hyperglycemia. Led to the significant
nature underlying diabetes, oral hypoglycemic agents medications (OADs) might not have
been sufficient for patients 65 and older with type 2 diabetes to support and sustain long-
term glucose control (Valencia et al., 2019). When oral antihyperglycemic medications
(OADs) are no longer beneficial in enhancing optimal glucose tolerance, it is suggested that
a diagnosis of acute be made, in particular the lengthy benchmark analogue insulin glargine,
for both the management of T2DM (Slabaugh et al., 2015). Removable insulin pens have
several advantages over vial and syringe administrations, including preference,
confidentiality, convenience of use, unambiguous dosing, and greater accuracy during
administering low dosages (Ramadan et al., 2015). Portable insulin syringes might be
especially helpful for people experiencing mobility or eyesight limitations (Miao et al., 2014).

Aims and objectives

Previous retroactive databases study revealed that individuals who began treatment with a
disposable pen instead of a vial, as well as a syringe, had superior medical and economic
outcomes (Bahendeka et al., 2019). Whether or not an ageing population will have the same
advantages is unclear at this time. The purpose of this research was to examine whether or
not there was a difference in clinical and economic consequences between administering
insulin series of innovative and using a vial as well as syringe versus a single-use pen in
some kind of a community of elderly people.

References
Miao, R., Wei, W., Lin, J., Xie, L., & Baser, O. (2014). Does the device make any difference? A real-
world retrospective study of insulin treatment among elderly patients with type 2 diabetes. Journal of
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Slabaugh, S. L., Bouchard, J. R., Li, Y., Baltz, J. C., Meah, Y. A., & Moretz, D. C. (2015).
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Bahendeka, S., Kaushik, R., Swai, A. B., Otieno, F., Bajaj, S., Kalra, S., ... & Karigire, C. (2019).
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