3 Thoughts About The V-Go Insulin Delivery Device
July 19, 2012 19 Comments
I had a chance this week to spend some hands-on time learning about the new V-Go insulin delivery device from Valeritas. Valeritas’ website states that “The V-Go is engineered to simplify basal–bolus insulin therapy for the millions of people suffering from Type 2 diabetes.”
– This is the first disposable insulin-delivery device that will give basal-bolus insulin.
– It is mechanical, containing no electronics.
– It is designed to be worn for 24 hours before it needs to be refilled with insulin.
– The needle is a 30 gauge needle that stays in the user while the V-Go is in use.
– The V-Go comes in 3 “sizes”: one that delivers 20 units of basal insulin over 24 hours, one that delivers 30 units, and one that delivers 40 units. Each device is also capable of giving bolus insulin in 2 unit increments up to 36 total units of bolus insulin per 24 hour period.
Three thoughts about the V-Go:
1) Convenient: This device appears well-built and relatively easy to use. It is about the size of an Omnipod, and because it is placed on the user for 24 hours straight, allows her to leave insulin at home when going out for the day. The device needs to be refilled every 24 hours with rapid-acting insulin. So, the user need only take fingerstick/testing supplies out with her when going to work, running errands, or going out to meals. It is also somewhat elegant that there are no electronics in the device.
2) Not enough insulin: Though this device promises convenience, unfortunately, the amount of insulin that can be delivered is too little for many type 2 diabetes patients. The most that can be delivered is 40 units of basal insulin and 12 units of bolus insulin per meal (totaling 36 units of bolus insulin a day). In my eyes, this is a “type 1 diabetes amount of insulin” in a device intended for people with type 2 diabetes. The company believes that by improving adherence to insulin regimens and by dosing around the clock with rapid-acting insulin, people will need less insulin than they currently take. This may be true, but I am still skeptical that this device will deliver enough insulin to meet the needs of many of my patients.
3) Inability to titrate: The device comes in 3 sizes, each delivering a set basal amount of insulin over 24 hours. These are either 20, 30, or 40 units. While this may be useful for a patient who has already been on a steady dose of basal insulin, it does not give much flexibility to titrate doses. Once a patient has paid her co-pay at the pharmacy and picked up a month’s supply, she would have to pay again to switch to a different basal rate.
I think this device represents an interesting start towards a market that will likely increase rapidly in the next few years of devices intended to deliver insulin to people with type 2 diabetes. Given the above limitations, I think it’s overall usefulness will prove limited, but I look forward to seeing what future iterations and generations of devices will look like.
What do you think? Would you want to try this (either patients with type 2 diabetes or providers caring for patients with type 2 diabetes)?