In a study funded by Novo Nordisk, researchers at Ohio State University have found that type 2s who move from oral meds to insulin would be wise to start with an insulin pen rather than a syringe.

It's not because the pens cost less than syringes and vials; in fact, they cost more. Rather, it's because type 2s who start their insulin with pens end up requiring much less medical care.

The researchers compared 1,162 type 2 Medicaid patients who began insulin therapy with syringes to 168 who began insulin by using Novo Nordisk insulin pens. They found that only about half the people in either group took their insulin properly, a fact that they attributed to the poor overall care that low-income people receive from Medicaid.

After summing up the costs of each group's emergency room visits, hospitalizations, and outpatient visits for diabetes-related conditions, the average cost for pen users was $14,857 a year. For syringe users, however, it was a whopping $31,764.

In another study, the same researchers compared more than 1,100 patients who were already on insulin when the study began. Half switched to a pen, and half stayed on injections. In that study, annual healthcare costs of pen users were more than for syringe users: $11,476 versus $10,755.

The researchers explained this contradictory finding by noting that pens are more expensive initially. They also hypothesized that pen users probably took their insulin as often as they were supposed to and that syringe users probably didn't, resulting in higher insulin costs for the pen users.

Source: EurekAlert; Clinical Therapeutics, August 2007