In June 2016, we received an email from a doctor in California living with Type-1 Diabetes. Gary wanted to know everything about our needle-free device, the Comfort-in™ needle-free injector. Gary was previously using the Medi-Jector until the manufacturer shut down supply. After buying a kit, we quickly learned Gary was extremely happy with his purchase, we asked Gary if we could put his experience into words and below is his insightful reply:

Dear Comfort-in™,

I’m a physician, a pathologist by specialty. I’ve been in private practice for thirty years.
And I’m also an insulin-dependent diabetic.
Yes, doctors get sick, too. Doctors get cancer and die from it. They get hypertension, heart attacks and strokes. They suffer depression and anxiety. And they can become diabetic.

In the autumn of 1986 while I was studying for my board exams I began to develop the typical symptoms of Type 1 diabetes: polyuria, polydipsia and polyphagia. I was urinating frequently and, paradoxically, thirsty all the time. I was losing some weight even though I was eating well. I probably didn’t pay too much attention while preoccupied with such a critical examination. After the exam was over, though, I put two and two together and it finally dawned on me what was happening.

I’ll never forget that Friday morning going into the laboratory where I was in my fellowship and walking over to the urinalysis section. I asked the tech there if they wouldn’t mind doing a spot check on my urine for sugar. The tech pleasantly complied, handing me a cup for a urine specimen. They would drop a small tablet into the specimen. A green color was negative. Yellow to orange was positive. I was quietly stunned and scared when my urine bubbled and turned a violent shade of orange. We tried a second time. Same result
I called one of the staff endocrinologists who was also available to hospital employees. He said, “I want to see you in my office right now.”
They had a blood glucose analyzer in his office. A nurse drew my blood and I sat alone in the examining room, waiting. Then the doctor walked in and calmly told me, “Your blood sugar is 447. You have diabetes. You’re going to need insulin for the rest of your natural life.” December 12, 1986 about 2:00 p.m. Not that I’m trying to remember, mind you.
My endocrinologist made me take my very first shot right then and there. I had to take a syringe with a needle and inject myself.
To make a long story short together my endocrinologist and I got my diabetes under superb control. I measure my blood sugar regularly every day and, as a result, I can’t be out of control for more than an hour or so without knowing about it. But I still had to take multiple shots a day. I was now facing a lifetime of needles. You can imagine how I felt.

I was also wrong.

A few months after I was diagnosed I learned there were devices that injected insulin without needles. I later learned that they had already been in existence for many years, that the military used them during World War II to vaccinate large numbers of soldiers. The devices had been refined, miniaturized and were now available to the public.
The various devices on the market all work the same way. An ordinary insulin bottle is mounted into an adapter made by the same manufacturer. The insulin is drawn into a chamber or syringe at the tip of the device. The device itself works using a powerful spring. You press the syringe up against your skin. Then you push a button to release the spring. The insulin is forced out of the syringe at high speed. The insulin will pierce the skin and travel into the subcutaneous fat. Instant injection. No needles required.
The salesman for the company that made the device I chose told me he wasn’t a diabetic but he demonstrated the device on himself multiple times a day using harmless sterile saline. He also pointed out that he had to caution people when they first began using such a device that they might need less insulin. The reason is very simple. Injecting insulin with a needle creates a pool at the needle tip. But a needle-free device is different. It creates a spray that disperses like a cloud. You can see it yourself if you ever see such a device sprayed into the open air instead of against the skin. The insulin, being dispersed better in the subcutaneous adipose tissue, absorbs better thus the possible requirement for less insulin.
I’ve been using needle-free devices ever since. I began in the spring of 1987. Look at your calendar. You do the math.
Such devices are durable and warrantied for years. They even cost as little to use over the long haul as needles do, at least here in the U.S. I’ve already gone through several devices. When one needle-free device finally breaks I don’t even think about going back to needles. I just order a new device. ASAP, of course.

In passing, I should mention that I’ve been demonstrating my needle-free device to innumerable curious people over the years. No one and I mean no one, knew about them. Even other physicians didn’t know they existed.
So how does it feel to use such a device? Needles are stone-age. Needle-free devices are space age. I mean, we’re talking about the difference between a good quality horse and a six-figure sports car equipped with air conditioning and a state-of-the-art sound system. Both get you there but there’s a tremendous difference in the ride.
Quite frankly, when I use a needle-free device I don’t even feel like a diabetic. To me, a diabetic is someone who has to stick themselves with needles. I don’t even think of using a needle-free device as a “shot”.

The emotional difference is huge. No one wants to stick themselves with a sharp object. Putting a needle-free device up against your skin and pushing a button is trivial in comparison. It doesn’t even feel like a “shot”. Having experienced both I can tell you that although the makers of needles try to make them as fine and as painless as possible there’s always a dull ache at the site of the shot that lasts a while afterwards. With a needle-free device you often don’t even feel it (“Did I just give myself an injection?”) and even when you do I can tell you any sensation vanishes almost immediately, doesn’t linger and never comes back.

And when I say “space age” I’m not joking, either. I grew up watching the original classic “Star Trek” as a boy. Remember Dr. McCoy’s injecting instrument? It was a hypospray that he simply pushed up against the patient’s skin and fired. I never dreamed that such devices even existed (or that I would one day need one). Well, wherever you are, Bones McCoy, eat your heart out.
Suffice it to say that if one of my sons ever develops diabetes the first thing I’m going to do is get him a needle-free device so he’ll never have to deal with years of stabbing himself with sharp objects over and over. Thankfully, it just isn’t necessary anymore.

Dr. Gary Garshfield
Orange County, California
11/28/2016

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