BACKGROUND: Patients with type 2 diabetes often suffer from impairments in vision as well as manual dexterity. The purpose of this study was to assess the reliability of dose selection and setting of five insulin devices by patients using auditory and sensory confirmation. METHODS: A total of 48 patients (30 men, 18 women; mean +/- SD age 60.5 +/- 14.0 years; hemoglobin A(1c) 8.7 +/- 1.9%) were randomized to test the following devices: NovoPen 3 (Novo Nordisk A/S, Bagsvaerd, Denmark), HumaPen Ergo (Eli Lilly, Indianapolis, IN), Humalog Pen (Eli Lilly), InnoLet (Novo Nordisk), and FlexPen(Novo Nordisk). RESULTS: Significantly more patients detected an auditory confirmation of dose setting when using the NovoPen 3 compared with the Humalog Pen (P