Inpen review: smart insulin delivery via mdi

WRITTEN BY: Alexi Melvin

Confessions of a pump user

Okay, I’ve tried to be a pump person. I’ve tried several times, and I am not dismissing the idea of giving it another go sometime in the future, but that time is not right now. I enjoy being on multiple daily injections (MDI). Most days, it fits my lifestyle quite well. But there are elements of wearing a pump that I frequently miss.

InPen, developed by Companion Medical, is breaking ground for people with diabetes on MDI that has already been broken for people using an insulin pump. The InPen is a “smart insulin delivery system” in the form of a reusable insulin pen.

The pen is able to pair via Bluetooth® with its corresponding smartphone app (and comes in a variety of spiffy colors!). This allows for a ton of helpful data to be stored conveniently within the app on your phone. You can keep track of exactly how many units you injected throughout the day, as well as the timing, and how many units of insulin you still have on board (IOB). The insulin on board feature is probably my favorite. It makes it so much easier for me to gauge whether or not I will potentially go low if I take a correction at a certain time.

Need to know

When you open the InPen app, you can enter your current blood sugar and number of carbs that you’ll be eating, and it will give you a suggested dose. These suggestions are based on your own insulin to carb ratio and other pertinent diabetes management information that you input into the app when you get started with InPen. If you enter a BG level that is on the low side, the app will even suggest an amount of carbs to eat. The InPen app will also ask what long-acting insulin you are currently taking and set a reminder to log each long-acting dose each day. The pen can deliver 0.5 to 30 units of insulin, and InPen makes it possible to deliver half units.

The injector pen is compatible with Lilly Humalog and Novo Nordisk Novolog U-100 3.0 mL insulin cartridges and it requires single-use detachable and disposable pen needles as prescribed by your doctor. The pen lasts for one year and there is no recharging needed.

You can also share the data tracked by the pen and delivered to the InPen smart app with your doctor to use at your next endocrinologist visit and with loved ones. If you have an iPhone, you will also be able to link your Health app data as well as Dexcom CGM data to the InPen app.

To sum it up

Technology, as we know, is not perfect. And although the InPen typically communicates quite well via Bluetooth with the app, make sure to keep your phone within a few feet of the InPen when you are giving yourself a dose. Otherwise, the dose won’t immediately register in the app, which could throw off your data until the pen is back within range of your smart phone.

It is a wonderful feeling, as someone on MDI, to be able to have all of my data in one convenient place, rather than needing to keep track of my doses with my own notes or in my head. The InPen has given me extreme peace of mind throughout my days managing Type 1 diabetes, and I would absolutely recommend it to anyone in the same position — or for anyone who is looking for a pump break, this would be an incredibly smooth transition back to MDI.

To learn more about InPen and how to try it out for yourself, talk to your doctor and get more information here.

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I have the in pen and am extremely disappointed. The delivery feels like I went back to 2000 with the novo pen3…30 units max, it does not tell you how much is left near the end of the cartridge, at the end of the cartridge it feels like you are breaking it while you unwind which seems to take forever… this was obviously designed by engineers who never touched a humapen savvio, novopen 4, novopen echo, Owen Mumford auto pen, all 4 of these are better and I would gladly give up Bluetooth for a smooth insulin delivery…the Bluetooth worked on their app, but the app constantly drains your battery with useless notifications… why didn’t you take your lunchtime insulin?, your in pen is not connected, dinner insulin?, etc. I anticipated that the app would be useless, but I did not expect the constant useless reminders, the worst insulin delivery in a pen I have ever experienced, and the only reason I wasted $35 was because I saw xdrip options, which did not work…

I am also somewhat disappointed in the quality of construction. It feels very breakable to me in comparison with the Novopen Echo. Manually winding the plunger back into the pen to load a new cartridge seems like a poorly thought out design. I also feel like I end up wasting the last part of a vial because I am afraid I will run out at work due to not being able to gauge how much is remaining with the dial. I wish the clip was just a little longer (or the pen a little shorter) so that it would securely fit in my shirt pocket. There have been several times when it has come unclipped and fallen out…so far, not when I’ve been looking down a hole!

The thing I like is that it tracks my insulin use automatically and reports that to the Dexcom app with my CGM. I was a little unreliable in keeping that record (miss one day and your averages are off!).

I would not call it a smart pen, but it does do the math for calculating a dose. That was never really a problem for me.

I’m sacrificing Bluetooth for knowing how much insulin is left towards the end and an easy cartridge change using the humapen savvio(2013 not fda approved, 60 unit max and you have to buy from anywhere except the u.s.) I will occasionally use the auto pen until its low, then switch to the savvio since the autopen is like the in pen, And won’t tell you what’s left in the cartridge… the auto pen has to unwind at the end, however, it does not feel like it is about to break when you do it, and insulin delivery is auto

I see the advantages of pumping but am still MDI and doing great with it (as always, emphasis on the M, which is why it still works well for me). For those who want the logging capability, yeah that seems great, and whatever works right? I use pen and paper or notes on my phone. I kind of like how these trends all seem to be converging on the universe of looping in one form or another.
Thanks for the review!

Seems like this is all about bolus dosing, and calculating and tracking same. But the real value of using a pump is in managing basal delivery. Not just the thing of programming different rates, but also being able to adjust on the fly. If you need to set a temp rate, you set a temp rate. Can’t do that with a Lantus injection you already took several hours ago. On the bolusing side, too, there are things like dual wave delivery, which you can kinda-sorta approximate with a pen injector but is much more of a hassle. I understand why some people don’t want to transition to a pump, it’s more complicated to program and has many failure points compared to the relative simplicity of an injection. But having made that transition, I wouldn’t go back unless “Smart” pens got a lot smarter than this.

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I personally had a pump and used it for about 5 years, however, on my 2nd or third day, it would always stop working or lose adhesion when I was not at home, or during a vacation, etc., at work…I suppose I could have carried an extra vial of insulin, an extra pump Infusion kit, along with my glucometer,…too much stuff…I might consider it if my insurance covered them, however, I haven’t had a plan that covered pumps or Cgms for about 25 years now… I purchase the libre and miaomiao2 out of pocket due to my high deductible, and suspect most people on MDI are in the same high deductible predicament, or gained too much weight on the pump, or had it keep falling off, etc. I still think tresiba makes A huge difference with MDI, and of course the libre or Cgms. And the in pen or companion medical should be ashamed of themselves for creating the worst insulin pen ever. Worst app without any Cgm import features, constant battery draining notifications, no idea how much insulin is left in the cartridges, difficult clicking delivery with A larger pen which makes it more difficult, virtually impossible to give an arm dose

Yeah, like I say, too many failure points for some to tolerate. I’ve given some thought to going back to MDI just on the basis of I feel like I’m running out of territory for infusion sites. I have scarring from abdominal surgery, which limits the available area, and am about to have another bout of it, so that was one of the reasons I clicked on this story. Doesn’t look like this device is going to make that decision for me though.

I love the Owen Mumford auto pen and the humapen savvio, although the savvio is a Canadian purchase, as the fda did not like the 60 unit max…and Apparently knowing how much is left in the cartridges was not important to the Fda…I also log my insulin in xdrip which also shows up on ns client, which also shows up if I ask Alexa… she will announce insulin on board… I would recommend a pump break just to heal for a little bit, but that’s just me

I’m on Tresiba for my basal and I do adjust it based on level of activity. On days that I exercise vigorously I take 1 unit less than other days so yes, it’s not very flexible. The bolus has to take care of everything else. The first time I’ve really thought a pump might be worth considering for me was when I read about “super bolusing” by increasing the basal dose for a short period. Every now and then I like a good hamburger or steak, so that would be better than having to take another shot 2 hours after eating.

I will say that Tresiba has really been good for me as it is more forgiving of varying shot times that Lantus was.

I do get the insulin doses reported to my Dexcom app and I’ve turned off almost all of the notifications, but the rest of the issues you mention are designed in, unfortunately.

Insulin pumps always felt like way too much work for me for poor control. I started pumping in 1998. I now have a1c between 4.4 and 5 with MDI and dexcom g5.

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So far I’m not very interested in pumps. I think they have good benefits but the fact they can/will fail for different reasons means I have to carry around infusion sets and insulin anyway. If I’m going to have to carry insulin everywhere it might as well be a pen (Not InPen).

I’m not sure what to expect for scaring with infusion sites but I feel like it will be a very long time before I have issues with MDI since its easy to spread around locations and its smaller doses each time.

When looking at InPen mixed with Dexcom it looks like you can only see the CGM data from 3 hours ago in the InPen app, is that right? If so that seems really useless for decision making.

Chris I doubt it will ever happen to he honest with MDI. Ive been injecting for 44 years and I don’t have a single area where I cant inject, I also do IM shots (and the odd IV). When I was between 10 to 15 years old I started to develop a thick patch from using the same spot on my rear over and over with monotard zinc suspension insulin, but it has long disappeared and cleared up, but I learned my lesson and like you just inject in a different spot every time now.

You can try using Regular insulin. It’s not perfect, but it has a delayed onset of 45 min to an hour, peaks at 1.5-2.5 hours and lasts 6-8 hours, so it can be used to approximate a basal increase/extended bolus on MDI. I often combine it with Fiasp when eating a high fat/protein meal like a burger and fries. It is also great for pasta and some desserts.

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The CGM data shows up in the reports. You can use it to figure out what you should have done, but not what you should do next. I manually enter the CGM reading and the number of carbs in my meal and it calculates a recommended dose based on the settings I have entered for units per carb, units per BG value, and duration of insulin. I think they are adding some other capabilities.

See my personal review here: InPen Smart Insulin Delivery + G6

I never wanted a pump. It seemed like the biggest annoyance. However now I have one I can’t go back and I’ve tried. I took a pump vacation a few times and it was very difficult.
I carry nothing with me day to day. I don’t carry insulin besides what’s in my pump.
I have an extra infusion set and a syringe in my car.
That’s it.
I can draw insulin out of my cartridge if I ever needed to but over 20 years on a pump and I have only done that once.

I agree, 3 hours ago sounds like south park’s captain hindsight… have you tried xdrip with an Android wear watch? It allows you to log insulin doses on your watch (keypad treatment), and the predicted lows help me a lot.