Alternatives to Injections. Insulin pumps have become more reliable and easy to use, and studies are finding that those who use them have fewer hypoglycemic episodes than intensive insulin therapy and their quality of life is higher. Some pumps are worn externally, and the wearer can program them to deliver insulin through a catheter in the skin or the abdomen. The box-like programming device is lightweight, about the size of a pack of cards, and has a digital display.

Programmable pumps are proving to improve qualify of life, control blood glucose, and reduce hypoglycemia compared to injections. In type 2 diabetes, they are also reducing the need for antihypertensive medications. They are more expensive than insulin shots, however, and have complications, such as blockage in the device. An inhaled aerosol spray is proving to be as effective as injections. A large study is underway. Other promising avenues of investigation are use of ultrasound pulses to deliver insulin through skin patches, and implanted pellets.

Some studies are testing oral or inhaled insulin to prevent type 1 diabetes in people with close relatives with the disease and who show evidence of beta-cell deterioration.

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