{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T22:19:26Z","timestamp":1792880366443,"version":"4.5.0"},"reference-count":69,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T00:00:00Z","timestamp":1639094400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017412","name":"BD","doi-asserted-by":"publisher","award":["not applicable"],"award-info":[{"award-number":["not applicable"]}],"id":[{"id":"10.13039\/100017412","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Diabetes Sci Technol"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:p>Innovations in syringe and pen needle (PN) technology over the last 100 years have led to important advances in insulin delivery for people with diabetes, paralleling the strides made in developing recombinant DNA human insulin and insulin analogs with varying onset and duration of action. In this review, the history of advances in insulin delivery is described, focusing on progress in syringe, needle, and PN technologies. The early glass and metal syringes that required sterilization by boiling have been replaced by disposable, single-use syringes or pens with clear labeling for precise insulin dosing. The early needles ranging in length from 19 to 26 mm that required manual sharpening against a whetstone have been replaced by syringe needles of 6 mm and PNs of 4 mm in length as slender as 34 gauge. Imaging studies using ultrasound and computed tomography measured the thickness of skin and subcutaneous tissue layers to show feasibility of targeted insulin administration with shorter needles. These developments, coupled with innovations in needle\/PN wall and tip structure, have led to improved injection experience for people with diabetes. It is also important to acknowledge the role of injection technique education, together with these advances in injection technology, for improving clinical outcomes and patient satisfaction. With continued projected growth of diabetes prevalence, particularly in developing countries where expensive and complex insulin delivery systems may not be practical, insulin syringes and pens will continue to serve as reliable and cost-effective means of insulin delivery for people with diabetes.<\/jats:p>","DOI":"10.1177\/19322968211059564","type":"journal-article","created":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T05:06:10Z","timestamp":1639112770000},"page":"449-457","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["Needle Technology for Insulin Administration: A Century of Innovation"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2493-1304","authenticated-orcid":false,"given":"Lutz","family":"Heinemann","sequence":"first","affiliation":[{"name":"Science Consulting in Diabetes GmbH, Kaarst, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3169-2460","authenticated-orcid":false,"given":"Trung","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Becton, Dickinson and Company, Eysins, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy S.","family":"Bailey","sequence":"additional","affiliation":[{"name":"AMCR Institute, Inc., Escondido, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Hassoun","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, Fakeeh University Hospital, Dubai, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Kulzer","sequence":"additional","affiliation":[{"name":"Research Institute Diabetes Academy Mergentheim, Bad Mergentheim, Germany"},{"name":"Diabetes Center Mergentheim, Bad Mergentheim, Germany"},{"name":"University Bamberg, Bamberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Oliveria","sequence":"additional","affiliation":[{"name":"Becton, Dickinson and Company, Eysins, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yves","family":"Reznik","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetology, CHU C\u00f4te de Nacre, Caen, France"},{"name":"Medical School, University of Caen Basse-Normandie, Caen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harold W.","family":"de Valk","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7854-4233","authenticated-orcid":false,"given":"Julia K.","family":"Mader","sequence":"additional","affiliation":[{"name":"Division of Endocrinology & Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,12,10]]},"reference":[{"key":"bibr1-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1177\/193229681200600428"},{"key":"bibr2-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-020-00831-z"},{"key":"bibr3-19322968211059564","unstructured":"Dickinson FS, Inventor. Hypodermic syringe. US patent US1742497. January 7, 1930. https:\/\/patents.google.com\/patent\/US1742497A\/en. Accessed August 31, 2021"},{"key":"bibr4-19322968211059564","unstructured":"Whitney EH, Inventor. Disposable Luer lock syringe. US patent US4220151A. September 2, 1980. https:\/\/patents.google.com\/patent\/US4220151A\/en. Accessed August 31, 2021."},{"key":"bibr5-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1177\/193229681100500404"},{"key":"bibr6-19322968211059564","doi-asserted-by":"publisher","DOI":"10.3810\/pgm.1999.10.15.751"},{"key":"bibr7-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-019-0585-7"},{"key":"bibr8-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1185\/03007995.2010.482499"},{"key":"bibr9-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1185\/03007995.2010.481203"},{"key":"bibr10-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1924.26610020002018b"},{"key":"bibr11-19322968211059564","doi-asserted-by":"publisher","DOI":"10.17925\/USE.2013.09.02.114"},{"key":"bibr12-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.292.6536.1638"},{"key":"bibr13-19322968211059564","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.11.1.41"},{"key":"bibr14-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.284.6333.1929"},{"key":"bibr15-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1136\/adc.66.7.879"},{"key":"bibr16-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.1992.tb01731.x"},{"key":"bibr17-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9136(1998110)15:11<965::AID-DIA691>3.0.CO;2-Y"},{"key":"bibr18-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5448.2012.00865.x"},{"key":"bibr19-19322968211059564","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.13.5.473"},{"key":"bibr20-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.1990.tb01431.x"},{"key":"bibr21-19322968211059564","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.18.7.986"},{"key":"bibr22-19322968211059564","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.19.12.1434"},{"key":"bibr23-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2014.0111"},{"key":"bibr24-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1080\/08990220600700925"},{"key":"bibr25-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1002\/pdi.1960160512"},{"key":"bibr26-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1002\/pdi.1960160711"},{"key":"bibr27-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2004.10.007"},{"key":"bibr28-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2014.12.014"},{"key":"bibr29-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2011.0010"},{"key":"bibr30-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2016.06.010"},{"key":"bibr31-19322968211059564","volume":"44","author":"9. Pharmacologic approaches to glycemic treatment: standards of medical care in diabetes-2021","year":"2021","journal-title":"Diabetes Care"},{"key":"bibr32-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1177\/193229680700100517"},{"issue":"6","key":"bibr33-19322968211059564","first-page":"e8673","volume":"12","author":"Al Hayek AA","year":"2020","journal-title":"Cureus"},{"key":"bibr34-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1002\/edn.77"},{"key":"bibr35-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjd.2014.09.008"},{"key":"bibr36-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2008.0027"},{"key":"bibr37-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2008.0054"},{"key":"bibr38-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1016\/S1090-3801(99)90187-8"},{"key":"bibr39-19322968211059564","unstructured":"Schneider LW, Peck LS, Melvin JW. Penetration characteristics of hypodermic needles in skin and muscle tissue. Phase I (Report No. UM-HSRI-78-23). Ann Arbor, MI: Highway Safety Research Institute; 1978. Accessed August 23, 2021. https:\/\/hdl.handle.net\/2027.42\/613."},{"key":"bibr40-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.303.6793.26"},{"key":"bibr41-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2016-000266"},{"key":"bibr42-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0104054"},{"key":"bibr43-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1177\/193229681200600216"},{"key":"bibr44-19322968211059564","first-page":"311","volume":"12","author":"Leonardi L","year":"2019","journal-title":"Med Devices (Auckl)"},{"key":"bibr45-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2009.0048"},{"key":"bibr46-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2013.05.020"},{"key":"bibr47-19322968211059564","volume":"66","author":"Rini CJ","year":"2017","journal-title":"Diabetes"},{"key":"bibr48-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1177\/1932296819836987"},{"key":"bibr49-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2020.1803248"},{"key":"bibr50-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcte.2020.100217"},{"key":"bibr51-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-020-00913-y"},{"key":"bibr52-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-017-0315-y"},{"key":"bibr53-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabet.2013.05.006"},{"key":"bibr54-19322968211059564","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2018.00638"},{"key":"bibr55-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-020-00876-0"},{"key":"bibr56-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2017.01.020"},{"key":"bibr57-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2017.0165"},{"key":"bibr58-19322968211059564","doi-asserted-by":"publisher","DOI":"10.2337\/ds20-0054"},{"key":"bibr59-19322968211059564","first-page":"193229682098386","volume":"2021","author":"Heinemann L","journal-title":"J Diabetes Sci Technol"},{"key":"bibr60-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2020.0187"},{"key":"bibr61-19322968211059564","doi-asserted-by":"publisher","DOI":"10.3390\/pharmaceutics12060569"},{"key":"bibr62-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1177\/1932296814530060"},{"key":"bibr63-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2016.0156"},{"key":"bibr64-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2010.0184"},{"key":"bibr65-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1177\/193229681200600403"},{"key":"bibr66-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1177\/1932296818778607"},{"key":"bibr67-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00618-8"},{"key":"bibr68-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2018-001258"},{"key":"bibr69-19322968211059564","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2019.107843"}],"container-title":["Journal of Diabetes Science and Technology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19322968211059564","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/19322968211059564","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19322968211059564","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T18:15:33Z","timestamp":1777400133000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/19322968211059564"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,10]]},"references-count":69,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1177\/19322968211059564"],"URL":"https:\/\/doi.org\/10.1177\/19322968211059564","relation":{},"ISSN":["1932-2968","1932-2968"],"issn-type":[{"value":"1932-2968","type":"print"},{"value":"1932-2968","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,10]]}}}