Body mass index and the efficacy of needle-free jet injection for the administration of rapid-acting insulin analogs, a post hoc analysis

We recently showed in a euglycaemic glucose clamp study among 18 healthy volunteers that using jet injectors rather than conventional pens significantly improved the time-action profiles of rapid-acting insulin analogs. Here, we investigated whether such profiles were modified by body mass index (BMI) and related weight parameters by comparing insulin administration by jet injection to that by conventional pen in subgroups defined by BMI, waist-to-hip ratio, waist circumference and insulin dose. After conventional administration, times to peak insulin levels (T-INSmax) occurred 31.1 [95% confidence interval (CI) 13.748.5] min later and time to maximum glucose requirement (T-GIRmax) 56.9 (95%CI 26.687.3) min later in more obese (BMI > 23.6 kg/m2) than in lean subjects (BMI < 23.6 kg/m2). In contrast, T-INSmax and T-GIRmax were similar in subjects with high and low BMI, when insulin was administered by jet injection. We conclude that using jet injection for insulin administration may especially benefit subjects with higher body weight.