A recent article (advertisement?) in Child Magazine (May 1996, page 78) describes a new product called Gentlejet which replaces the need for syringe injections with a new high-tech injection system. Gentlejet, it claims, "...breaks insulin into tiny particles and forces a microscopic stream of insulin through the skin without breaking the skin's surface." This sounds too good to be true. I called the number listed and requested information, but since I don't see this product referenced anywhere in your newsletter, I'm skeptical. Can you give a review/comments?
This question was referred to everyone on the Diabetes Team, who have each given an answer:
Answer from Dr. Lebinger:
I haven't seen the Gentlejet yet, so I don't know how it compares to the older models of jet injectors I have in my office. The companies have claimed that the insulin is absorbed faster, which could be a theoretical advantage for Regular insulin.
They used to recommend that you practice for two weeks with normal saline before trying insulin because you had to figure out how much pressure to use for each dose and each injection site. (The models I've seen in the past had different pressure settings. If you used too much pressure, it went too deep and was given intramuscularly. If you used too little pressure, it leaked out.) Either way you ended up with black and blues. One of my older patients who tried one got so many black and blues with the normal saline she was miserable. I had one patient who used the Medijector for a while and loved it--until it malfunctioned.
The old injectors had to be sterilized and you needed a special adaptor to fit it to insulin bottles. Remembering the days of glass syringes and steel needles, I personally think disposable syringes are much better than the injectors.
I explain to patients that "needleless" does not necesssarily mean painless.
Also of note, one of the companies used to warn not to point the injector at animals or children. One sales rep told me a story of someone who pointed it at a wall and put a hole in the wall, the pressure was so high.
Answer from Dr. Quick:
Personally, I think they're more trouble than they're worth. One of my diabetes nurse educators, who has IDDM, has tried them, and was turned off completely, and I don't have any of my patients on them (now or in the past).
Answer from Dr. Robertson:
I haven't tried one myself but I believe that they aren't painless - just quick!!
Answer from Ms Schwartz:
We recommend the device that's nicknamed "the rocket" (the Inject-Ease) for anybody who is shot-shy, and find it works well.
Original posting 9 Jun 96
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