What to Know About V-Go for Treating Type 2 Diabetes

A Disposable Insulin Pump That Comes as a Patch

Vials of insulin

Anthony-Masterson / Getty Images

V-Go is a prescription-only insulin delivery system for people with type 2 diabetes who require insulin in order to control their blood glucose (sugar). Like a traditional insulin pump, V-Go is a convenient alternative to needles and syringes for injecting insulin multiple times throughout the day—with one big difference: Whereas traditional pumps consist of an insulin reservoir (a device about the size of a small cellphone) that connects to the body with tubing, the V-Go is a credit-card size patch that adheres to the skin.

This means V-Go doesn't require batteries, infusion sets, or programming by a doctor. Designed to be used with fast-acting insulin, the patch can be worn on the stomach or the back of the arm, so it's easily hidden by clothing. After 24 hours, it is easily removed, discarded, and replaced with a new patch.

V-Go has been on the market since 2012. In research conducted by the manufacturer, Valeritas, Inc., V-Go was found to be as effective as multiple daily injections of insulin for controlling blood sugar and lowering the amount of total amount of insulin needed per day.

Your health insurance company may cover the cost of V-Go; be sure to check if and your doctor decide it's right for you.

Who Can Use V-Go

The patch is appropriate for adults 21 years and older with type 2 diabetes. It is not prescribed for people with type 1 diabetes (diabetes mellitus).

It should only be used by people who require 20, 30, or 40 units of basal insulin per day (basal insulin is produced continuously by the pancreas to keep blood sugar levels steady throughout the day and night).

Dosage

V-Go comes in three versions: V-Go 20, V-Go 30, and V-Go 40. The numbers refer to the amount of basal insulin that each delivers continuously during the 24 hours the patch is worn: V-Go 20 delivers 20 units of insulin over 24 hours, the V-Go 30 delivers 30 units, and the V-G0 40 delivers 40 units.

All V-Go devices deliver bolus insulin when needed in increments of two units at a time, up to 36 units per 24-hour time period. Bolus insulin is insulin put out by the pancreas in response to eating.

Insulin Options

Only two U-100 fast-acting insulin products have been tested by the manufacturer and found to be safe and effective for use with V-Go: Humalog ((insulin lispro) and NovoLog (insulin aspart). Your doctor will need to give you a separate prescription for your insulin—two vials are required for V-Go 20. V-Go 30 and V-Go 40 each require three vials of fast-acting insulin.

Using V-Go

The patch is easy to learn to use. Your doctor or healthcare provider can show you; the V-Go website also has detailed instructions and videos for how to use apply the patch, activate the flow of insulin, give yourself bolus injections, and store and dispose of the individual parts of the system.

Applying the Patch

To use V-Go, you simply fill it with insulin and attach it to your body, a process that should take a few minutes once you've mastered it. Here are the steps:

  1. Fill V-Go with insulin. This is done using a special device called EZ Fill that comes with V-Go. It's a small plastic case the patch slides into and into which the vial of insulin is attached. It takes about 30 seconds to completely fill the reservoir of the patch.
  2. Choose where to apply the patch. This can be anywhere you'd normally inject insulin, but the ideal spots are either your stomach, 2 inches away from your belly button or the back of your arm. Select a spot that is at least an inch away from where you previously applied a patch and make sure that the skin there is healthy and clear of signs of irritation, infection, or excess hair. Think about your activity plans for the day: Don't place V-Go anywhere the device might interfere with your clothing or a seatbelt, or be dislodged by rigorous physical activity.
  3. Prep your skin. Swab the area with alcohol and allow it to dry.
  4. Apply the patch. This is simply a matter of peeling away an adhesive liner (as you would a Band-Aid) and pressing the device onto your skin.
  5. Inject the needle. V-Go contains a pre-loaded needle. To inject it, you'll simply press a button on the patch. Your basal insulin will begin to flow freely into your body as soon as the needle is inserted.

Activating Pre-meal Insulin

A button on the patch will administer the bolus insulin you need before meals to cover the spike in glucose the occurs when food is eaten. You can press it discreetly, through your clothing. Bolus insulin is released in two-unit doses. V-Go will not allow you to click the bolus delivery button more than 18 times in a 24 hour period. Follow your doctor's directions for when to inject bolus insulin.

If while administering your bolus insulin you lose count of the number of units you've injected, stop, monitor your blood glucose, and follow the plan you and your doctor agreed to in this case, or call him or her for guidance.

While Wearing the Patch

V-Go is designed to be worn day and night under nearly any condition: You can shower and even swim with it on, although after it's exposed to water or you go into water that's 3 feet, 3 inches deep or deeper, be sure to check that the patch is still securely in place.

There are a couple of specific situations in which you'll need to remove the patch:

  1. During imaging tests, including X-rays, magnetic resonance imaging (MRI), and computerized tomography (CT) scans.
  2. While in a whirlpool, hot tub, or sauna: Before entering any of these, remove the V-Go you're wearing and replace it with a new fill V-Go afterward.

V-Go should not be exposed to direct sunlight, so be sure to cover up when you're out on a sunny day.

Removing V-Go

Before taking off the patch, you will need to retract the needle from your skin—again, a simple matter of pressing a button. Once the needle is out, you can safely and painlessly peel off the patch. It might leave a sticky residue behind on your skin that you can remove with warm soapy water and your fingertip.

Safe Disposal

Like all needles used to inject medication, V-Go should be disposed of according to local requirements. V-Go needles are designed to retract back into the patch after it's been removed so that it's completely contained. Even so, check to make sure the needle is covered; if it's not, press the same button you used to retract it from your skin.

Note that the EZ Fill should not be used for more than 30 fills. It too will need to be disposed of according to local regulations, with the last insulin vial used attached. You'll get a new EZ Fill every 30 days with your prescription.

Storage

Each time after you fill a new patch, leave the insulin vial attached to the EZ Fill and place in a clean, dry area of the refrigerator. Find a dry place to store your unused V-Go patches that's out of reach of children and pets.

Side Effects

There are two potential adverse reactions to using V-Go.

Skin irritation caused by either the adhesive or the positioning of the patch on your skin. This may be uncomfortable but is not a serious complication. Tell your doctor the patch is bothering your skin; you may be able to use a product that will create a barrier between your skin and the patch.

Infection or abscess. If the area around a V-Go you're wearing becomes red, swollen, or sore, remove it and apply a new patch to a different site that's away from the potentially infected area. Do not stop your insulin; call your doctor for guidance.

Warnings

As with any supplemental insulin, there is a risk of hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar) associated with using V-Go. According to the manufacturer, hypoglycemia can result "if regular adjustments or modifications to the basal rate of insulin are required in a 24-hour period, or if the amount of insulin used at meals requires adjustments of less than 2-Unit increments."

The rate at which V-Go delivers insulin can vary by up to plus or minus 10 percent from device to device, according to the manufacturer. This happens rarely, but it's advisable to monitor your blood sugar at least three times a day (or as often as your doctor tells you to), as well as before you drive or operate heavy machinery, since a drop in glucose levels can interfere with alertness.

Blood glucose of less than 70 mg/dL can mean you're hypoglycemic. Take immediate action to raise your levels by taking glucose tablets, eating candy, drinking juice, or otherwise doing as your doctor or healthcare professional has advised you to. After 15 minutes, retest: If the level of sugar in your blood is still below 70 mg/dL, continue to take steps to increase it until it reaches your normal level.

Hyperglycemia can progress to a potentially fatal condition called diabetic ketoacidosis (DKA), in which the blood becomes acidic and damage to cells can occur. Again, this is very unlikely to happen, but it's important to stay well hydrated and to know the signs of hyperglycemia so you can call your doctor if you think you may being developing it.

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