Updated March 31, 2008

Insulin Delivery Devices

by Stacy Griffin, Pharm.D., and Laura Hieronymus, M.S.Ed., A.P.R.N., B.C.-A.D.M., C.D.E.

Many people are willing to put in the work necessary to use an insulin pump because it gives them more flexibility with respect to food choices and the timing of meals and activities, while helping to achieve tighter control of their blood glucose.

Disposal of needles
Most states require that used needles and other "sharps" (such as lancets) be disposed of in a way that reduces the risk of accidental needle sticks. Once you've used a needle or lancet, place it in a puncture-resistant container such as a liquid detergent bottle or a sharps container purchased at your local pharmacy. (When traveling, carry a small container with you.)

Some communities offer a sharps disposal program that allows you to drop off your sharps at particular locations such as hospitals or pharmacies. If your area does not have such a program, discard your puncture-resistant sharps containers by placing the lid securely onto the container, taping it shut, and marking it "USED SHARPS." Place the container in the trash, not in a recycling container. Other options for disposing of sharps include sharps mail-back programs and home needle destruction devices.

Your diabetes care team can help you learn the guidelines that are specific to your state. Another place to find information on relevant state laws and regulations is the Center for Disease Control and Prevention Web site www.cdc.gov/needledisposal.

Traveling with diabetes supplies
When traveling, keep your diabetes supplies with you. Never place insulin or other liquid medicines in checked baggage, where they could be exposed to freezing or very hot temperatures. The Transportation Security Administration currently allows the following items on commercial airplanes once they have been screened at the security checkpoint in the airport:

• Insulin and insulin-loaded dispensing products (vials of insulin, jet injectors, pens, infusers, and preloaded syringes) that are clearly identified with a prescription label containing a name that matches the passenger's name on his ticket
• Other liquid prescription medicines such as Symlin, Byetta, or a glucagon emergency kit that are clearly identified with a prescription label containing a name that matches the passenger's name on his ticket
• An unlimited number of unused syringes, when accompanied by insulin or other injectable medicine
• Clearly labeled nonprescription liquid medicines, such as Regular insulin, which in some states does not require a doctor's prescription to dispense
• Blood glucose meters, test strips, continuous glucose monitors, lancets, and other monitoring supplies
• Insulin pump and insulin pump supplies
• An unlimited number of used syringes when transported in a sharps disposal container or other similar hard-surface container

In general, liquids, gels, and aerosols (such as toothpaste and shampoo) must be in three-ounce or smaller containers and must be placed in a single quart-size, zip-top plastic bag to be brought aboard an airplane. However, there are no limits on the amounts of prescription or over-the-counter medicines that come in a liquid, gel, or aerosol form that may be brought onto an airplane. These items should be packed separately from the items in the quart-size plastic bag.

Cost considerations
Always check with your insurance company to determine whether and which insulin injection devices and supplies are covered by your plan and what out-of-pocket costs are involved. If you do not have insurance coverage (or do not have prescription coverage), many pharmaceutical manufacturers offer patient assistance programs, which offer free or low-cost drugs and supplies to individuals who are unable to pay for their medicine. For more information, look on a specific company's Web site or the Web sites www.rxassist.org or www.needymeds.com, or contact the Partnership for Prescription Assistance either online, at www.pparx.org, or by telephone, at (888) 477-2669.

Dr. Griffin is a diabetes educator in Lexington, Kentucky, as well as a pharmacist at Central Baptist Hospital in Lexington, Kentucky. Laura Hieronymus has more than 20 years’ experience in diabetes care and education and is a Clinical Management Liaison for Amylin Pharmaceuticals, Inc.

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