Priyanka Majety, MD, discusses a new, FDA-approved wearable insulin-delivery patch that could potentially improve patients’ insulin adherence as well as their quality of life.
Last summer, a wearable patch designed for mealtime insulin delivery (in lieu of traditional injections) received clearance from the U.S. Food and Drug Administration, extending the patch’s wear time from three to four days, potentially eliminating 12 mealtime insulin injections.
The CeQur Simplicity is an insulin patch that weighs only about 10 grams and can hold up to 200 units of short-acting insulin, using a flexible cannula that administers insulin and allows for on-demand dosing with each click, delivering two units of insulin.
Priyanka Majety, MD, assistant professor in the Division of Endocrinology, Diabetes, and Metabolism at Virginia Commonwealth University in Richmond, says that while she doesn’t offer this option to all her patients with diabetes she sees in her clinic, she believes there is a specific niche of patients who could greatly benefit from this device, especially those with needle phobia, who forget to carry the insulin pens to work, or individuals who wish for a more discreet way to give themselves insulin. “For example, I have a kindergarten teacher who does this so that her students are not exposed to needles,” she says.
Majety goes on to say that the patients she offered the patch to were excited to use something other than multiple daily injections. “These were patients who did not want to inject insulin several times a day for various reasons,” she says. “We teach them how to load it with insulin, how to change it, and at the beginning to address concerns regarding switching from familiar methods like syringes and pens. When I introduce this patch in my clinic, I emphasize its ease of use and the potential for better adherence to insulin therapy.”
Majety tells Endocrine News that she recently had a patient diagnosed with diabetes after a total pancreatectomy and autologous islet cell transplant, who found managing injections and daily glucose checks overwhelming and gradually stopped adhering to her regimen. “When she came to the clinic, motivated but frustrated with carrying pens and needles, we introduced her to the CeQur patch,” Majety says. “She was excited to learn about a less burdensome option. After some initial learning, she started using the patch and is now taking more mealtime insulin doses than before.”
And that improvement in compliance obviously leads to better outcomes. Many patients, Majety says, especially those with injection-related anxiety or those who forget to dose on time, find the simplicity and convenience of the patch appealing. By making mealtime insulin delivery as easy as a click, it promotes more consistent insulin administration.
Improving Patient Adherence and Quality of Life
Majety points to a 2019 study by Bergenstal, et al. in Diabetes Technology & Therapeutics, which was a multicenter, randomized controlled trial that compared the efficacy and safety of bolus insulin delivery using a wearable insulin patch versus an insulin pen in adults with type 2 diabetes who were inadequately controlled on basal insulin.
A total of 278 participants were followed for 44 weeks. The primary endpoint was a reduction in HbA1c, which improved by 1.7% in the patch group and 1.6% in the pen group, demonstrating non-inferiority. Glycemic control was maintained at 44 weeks. Both groups had similar rates of adverse events, with the patch showing a slight advantage in reducing blood glucose variability. “Importantly, patient and healthcare provider satisfaction were significantly higher with the patch, particularly for ease of use and social convenience,” Majety says.
“Although it is early, in my clinic, I’ve seen how this innovation can empower patients who may have previously been inconsistent with insulin therapy, ultimately contributing to better diabetes management outcomes.” — Priyanka Majety, MD, assistant professor, Division of Endocrinology, Diabetes, and Metabolism, Virginia Commonwealth University, Richmond, Va.
By week 48, a greater percentage of patients who used the patch expressed a preference for it over the pen. Safety profiles were similar, with no significant differences in severe hypoglycemia or weight gain between the two groups. “The study highlighted the patch’s potential to improve adherence and quality of life for patients managing mealtime insulin,” Majety says.
Increasing Accessibility
What’s more is this patch has the potential to be a game-changer for equity and accessibility, Majety says, especially for patients who may struggle with traditional insulin delivery methods due to factors like dexterity issues, injection anxiety, or differently abled.
Majety is careful here, though, saying that it’s important to raise awareness that this patch isn’t some sort of panacea; patients must still take their once-daily basal insulin to maintain comprehensive glucose control. The patch can improve adherence and quality of life, but education around its use in combination with basal insulin is critical for achieving optimal diabetes outcomes.
“These were patients who did not want to inject insulin several times a day for various reasons. We teach them how to load it with insulin, how to change it, and at the beginning to address concerns regarding switching from familiar methods like syringes and pens. When I introduce this patch in my clinic, I emphasize its ease of use and the potential for better adherence to insulin therapy.” — Priyanka Majety, MD, assistant professor, Division of Endocrinology, Diabetes, and Metabolism, Virginia Commonwealth University, Richmond, Va.
Majety goes on to say that more data is needed to understand the patch’s true impact, and that it would include longer-term studies to evaluate the patch’s sustainability and long-term impact on glycemic control and patient outcomes, as well as research on the patch’s use in diverse populations, including pediatric and elderly patients, could broaden its clinical application. Exploring the cost-effectiveness of the patch compared to other insulin delivery methods will also be crucial. Studies that assess the psychological benefits, such as reducing injection-related anxiety and improving quality of life, could further support its widespread adoption.
“[The patch’s] simplicity and reduced need for multiple daily injections make it more accessible for a broader range of patients,” Majety says. “Although it is early, in my clinic, I’ve seen how this innovation can empower patients who may have previously been inconsistent with insulin therapy, ultimately contributing to better diabetes management outcomes.”
Bagley is the senior editor of Endocrine News. In the January issue he wrote about the link between thyroid cancer and endocrine-disrupting chemicals in pregnant women of lower socioeconomic status.
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