In recent years, needles used to inject insulin have become shorter, sharper and thinner. In addition, a special silicone coating now makes it easier for the needle to penetrate the skin with a minimum of discomfort.

However, for patients who dislike needles, there are alternatives. In addition to the traditional syringe, there are several other methods used to deliver diabetes medications. These include:

• Insulin pen. This device resembles a pen containing a cartridge and a short, thin needle on one end and a plunger at the other. Insulin pens have a dial that patients use to select the insulin dosage level they need. Some insulin pens use replaceable cartridges, and others are completely disposable.
  
  

  

• Inhaled insulin. U.S. and European regulators in 2006 approved a powder, inhaled through the mouth via a device, as the first available form of inhaled insulin. It can be used by adult nonsmokers with type 1 diabetes or type 2 diabetes. Some patients, including those with type 1, still need to inject some long-acting insulin.
  
  
• Insulin jet injector.  A high-pressure air mechanism sends a fine spray of insulin through the skin without an injection. Though needles are not used, some patients find the high-pressure air painful. In addition, some of the medication can be lost during delivery.
  
  
• Insulin pump. This is a small, light device that the patient wears externally. The medication in the pump flows through a narrow, flexible plastic tubing with a needle at the end that is inserted just under the skin near the abdomen. These pumps deliver insulin throughout the day. Some models incorporate glucose meters, with a recent innovation being continuous glucose monitoring.

• Implantable insulin pumps. Though still considered experimental in the United States, these surgically inserted devices are available in Europe.

Researchers are developing other methods of insulin administration. These include inhaled sprays, pills and patches.