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Dialing torque preferences of people with diabetes when using insulin pens: a pilot study.

Friedrichs A, Schmitz M, Kamlot S, Adler S - Diabetes Ther (2015)

Bottom Line: In this pilot study, subjective ratings of dialing comfort for different insulin pens by participants appear to concur with previous laboratory dialing torque study results.There appears to be a "torque comfort zone." Torques above 50 N mm reduced subjective handling comfort.Further, larger scale studies are needed to establish that dialing torque affects pen users' comfort.

View Article: PubMed Central - PubMed

Affiliation: LWS Risk Management Consult GmbH, Brannenburg, Germany, arnd.friedrichs@lwsgroup.com.

ABSTRACT

Introduction: Ergonomic dialing torque may enhance safety and comfort when setting doses with insulin pens. Limited data are available on the correlation of dialing torque and dialing comfort.

Methods: Three studies were performed with SoloSTAR(®) (SS; Sanofi), FlexPen(®) (FP; Novo Nordisk), KwikPen(®) (KP; Eli Lilly) and FlexTouch(®) (FT; Novo Nordisk) pens. Dialing behavior was examined with 20 pen-experienced people with diabetes. Participants dialed up to the maximum dose and back down to "zero" with each pen. Hand and pen movements were recorded by video camera and rotational speeds and angles calculated for each pen. In a laboratory study, dialing torque was measured discontinuously at a speed of 120°/s, reflecting typical patient behavior. Sixteen pen-experienced people with diabetes participated in a pilot preference study. Using a Likert scale, subjective dialing comfort rankings and ratings were obtained for each pen type and matched to their dialing torque. SS, FP, KP, and FT1 were investigated at 0-20 U each and at 60-80 U for FT2.

Results: SS was ranked most comfortable for up-dialing by 8 and down-dialing by 6 of the 16 participants, respectively; FP, 5 and 8; FT1, 2 and 1; and KP, 1 and 1. FT2 was ranked least comfortable by 12 and 10 participants. Comfort for up- and down-dialing was rated "very comfortable" for SS by 15 participants each, followed by FP (12 and 14), KP (10 each), and FT1 (9 and 7); FT2 was rated "less" or "not" comfortable by 10 and 11 people, respectively.

Conclusion: In this pilot study, subjective ratings of dialing comfort for different insulin pens by participants appear to concur with previous laboratory dialing torque study results. There appears to be a "torque comfort zone." Torques above 50 N mm reduced subjective handling comfort. Further, larger scale studies are needed to establish that dialing torque affects pen users' comfort.

No MeSH data available.


Related in: MedlinePlus

Relation of dialing torque and dialing comfort for four disposable pens. Comfort rating was the total of best and second best ratings in the pilot study. The gray zone indicates the range up to 50 N mm as recommended by ISO 894–3:201015; n = 16 patients. FP FlexPen, FT1 FlexTouch (dialing from 0 to 20 U), FT2 FlexTouch (dialing from 60 to 80 U), KP KwikPen, SS SoloSTAR
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Fig4: Relation of dialing torque and dialing comfort for four disposable pens. Comfort rating was the total of best and second best ratings in the pilot study. The gray zone indicates the range up to 50 N mm as recommended by ISO 894–3:201015; n = 16 patients. FP FlexPen, FT1 FlexTouch (dialing from 0 to 20 U), FT2 FlexTouch (dialing from 60 to 80 U), KP KwikPen, SS SoloSTAR

Mentions: Results of the pilot comfort study suggest that people may have a preference regarding dialing torque (Fig. 4). The comfort of pens with high dialing torque was ranked and rated very low, suggesting that a torque exceeding 30 N mm [16] decreased perceived dialing comfort while torque levels of ≥50 N mm [15] appeared to induce dialing discomfort. Surprisingly, the pen with the lowest dialing torque (FP) was not rated or ranked best during the study. This suggests that either there is a comfort zone of dialing torques for people or that other factors influence their choice. It also suggests that an appropriate dialing torque might be a key feature of pen handling: discomfort might lead to deficient adherence to the therapy and consequently to problems in glycemic control, especially given the impaired manual dexterity of many people with diabetes mellitus.Fig. 4


Dialing torque preferences of people with diabetes when using insulin pens: a pilot study.

Friedrichs A, Schmitz M, Kamlot S, Adler S - Diabetes Ther (2015)

Relation of dialing torque and dialing comfort for four disposable pens. Comfort rating was the total of best and second best ratings in the pilot study. The gray zone indicates the range up to 50 N mm as recommended by ISO 894–3:201015; n = 16 patients. FP FlexPen, FT1 FlexTouch (dialing from 0 to 20 U), FT2 FlexTouch (dialing from 60 to 80 U), KP KwikPen, SS SoloSTAR
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4374073&req=5

Fig4: Relation of dialing torque and dialing comfort for four disposable pens. Comfort rating was the total of best and second best ratings in the pilot study. The gray zone indicates the range up to 50 N mm as recommended by ISO 894–3:201015; n = 16 patients. FP FlexPen, FT1 FlexTouch (dialing from 0 to 20 U), FT2 FlexTouch (dialing from 60 to 80 U), KP KwikPen, SS SoloSTAR
Mentions: Results of the pilot comfort study suggest that people may have a preference regarding dialing torque (Fig. 4). The comfort of pens with high dialing torque was ranked and rated very low, suggesting that a torque exceeding 30 N mm [16] decreased perceived dialing comfort while torque levels of ≥50 N mm [15] appeared to induce dialing discomfort. Surprisingly, the pen with the lowest dialing torque (FP) was not rated or ranked best during the study. This suggests that either there is a comfort zone of dialing torques for people or that other factors influence their choice. It also suggests that an appropriate dialing torque might be a key feature of pen handling: discomfort might lead to deficient adherence to the therapy and consequently to problems in glycemic control, especially given the impaired manual dexterity of many people with diabetes mellitus.Fig. 4

Bottom Line: In this pilot study, subjective ratings of dialing comfort for different insulin pens by participants appear to concur with previous laboratory dialing torque study results.There appears to be a "torque comfort zone." Torques above 50 N mm reduced subjective handling comfort.Further, larger scale studies are needed to establish that dialing torque affects pen users' comfort.

View Article: PubMed Central - PubMed

Affiliation: LWS Risk Management Consult GmbH, Brannenburg, Germany, arnd.friedrichs@lwsgroup.com.

ABSTRACT

Introduction: Ergonomic dialing torque may enhance safety and comfort when setting doses with insulin pens. Limited data are available on the correlation of dialing torque and dialing comfort.

Methods: Three studies were performed with SoloSTAR(®) (SS; Sanofi), FlexPen(®) (FP; Novo Nordisk), KwikPen(®) (KP; Eli Lilly) and FlexTouch(®) (FT; Novo Nordisk) pens. Dialing behavior was examined with 20 pen-experienced people with diabetes. Participants dialed up to the maximum dose and back down to "zero" with each pen. Hand and pen movements were recorded by video camera and rotational speeds and angles calculated for each pen. In a laboratory study, dialing torque was measured discontinuously at a speed of 120°/s, reflecting typical patient behavior. Sixteen pen-experienced people with diabetes participated in a pilot preference study. Using a Likert scale, subjective dialing comfort rankings and ratings were obtained for each pen type and matched to their dialing torque. SS, FP, KP, and FT1 were investigated at 0-20 U each and at 60-80 U for FT2.

Results: SS was ranked most comfortable for up-dialing by 8 and down-dialing by 6 of the 16 participants, respectively; FP, 5 and 8; FT1, 2 and 1; and KP, 1 and 1. FT2 was ranked least comfortable by 12 and 10 participants. Comfort for up- and down-dialing was rated "very comfortable" for SS by 15 participants each, followed by FP (12 and 14), KP (10 each), and FT1 (9 and 7); FT2 was rated "less" or "not" comfortable by 10 and 11 people, respectively.

Conclusion: In this pilot study, subjective ratings of dialing comfort for different insulin pens by participants appear to concur with previous laboratory dialing torque study results. There appears to be a "torque comfort zone." Torques above 50 N mm reduced subjective handling comfort. Further, larger scale studies are needed to establish that dialing torque affects pen users' comfort.

No MeSH data available.


Related in: MedlinePlus