Hi,
now that I've decided to try seriously to get some flatter lines I would need to dose very small amounts of insulin.
So how does one dose less than 1 unit to make corrections. I usually would not correct (in the past) unless I was higher than about 120. But if I want to do this really tightly I'm going to need to correct more agressively.
Do you just eyeball half a unit? How can you be correct with such small doses?
I use BD 1/2 marking syringes. I was once told in a thread on TuD told that the 1/2 marking syringes can be found in other brands as well, that Walmart's carry them in a different brand.
What about diluting your insulin 50/50 then a 1 becomes a 2. I seem to recall someone mentioning that there is a sterile solution that can be used for these purpose. Don't really know if this would work as I'm not an insulin user, just passing on something from another thread I happened upon.
Like Trudy, I also have syringes with 1/2 unit markings. But before I knew those were available, I eyeballed it. Very helpful to have 1/2 unit syringes to fine tune corrections, basal & bolus. Brand I use is Sure Comfort U-100 Insulin Syringes - Half Unit Short Needle, 31G 3/10 cc 5/16" http://www.americandiabeteswholesale.com/product/surecomfort-short-... ordered from http://www.americandiabeteswholesale.com/. Don't know if they ship internationally.
Great suggestion from BadMoon. I've never diluted insulin, but you can get sterile diluent. It's used to reconstitute powdered meds (like vaccines) for injections.
Just thinking out loud . . . this might be a good question for Bernstein's monthly broadcast. Or he may already have answered it, in which case it should be possible to look it up on his web site somewhere. I'd like to know the answer too, because I am in precisely the same situation.
Dr. B covers diluting insulin for children's doses in his book, if that's helpful. Half unit syringes are the easiest method.
Something I've noticed about injecting only a half unit is needing to leave the syringe in longer to make sure it doesn't leak out. Such a small amount doesn't have much force behind it.
BD makes syringes that have 1/2 unit markers. Depending on which insulin you use, some pens do also (I use Humalog, and Lilly makes one pen, the Luxura HD, that dispenses in 1/2 unit increments).
Bernstein will eyeball 1/4 unit! He would correct 110 with 1/4 unit. He uses syringes with 1/2 unit markings. It is easy to line up with the 1/2 unit mark because the lines are MUCH thinner than the standard syringes.
I can't imagine trying for 1/4 using my 1/2 unit syringes. Itty bitty amount that you can barely see.
Hi Gerri. I sometimes try for 1/4 unit, and I simply think of it as another use for SWAG.
Couple things, there are half unit syringes available, also you can try a pen injector that supports half unit dosing, and there is a sterile dilutent for insulin.. Lily has one, and i presume Novartis does as well.. theres always a pump, But its still very difficult and a bit of a swag when its just a half unit...
As far as I am concerned, there is no way to take an injection of 1/2 unit. All the syringes and pens that have 1/2 unit increments all have a minimum dose of 1 unit. In fact, for most of these that first unit is highly variable. If you really need to inject a 1/2 unit, you should look into diluting your insulin.
I take 1/2 unit frequently for a correction. The very first marking is a half, not a minimum of a whole unit.
Yes, Gerri is correct. The first unit marking is 1/2 unit. I take 1/2 unit almost on a daily basis with my BD 1/2 unit marking syringes.
I suck my Humalog out of insulin pen refill cartridges. I do not inject air- I just suck. I've been doing this for 5 or 6 years and have never had a problem. If I get too much, I just shoot the extra out into the air. I like it because the vials last too long for me, too. And I live in a hot climate and occasionally my insulin gets too hot. I'd rather replace a small cartridge than a whole vial.
Great you can get 1/4 unit. I'll have to give it a try. Half unit usually is usually the least I need. I've used slightly less than half, but couldn't say exactly how much that is.
The rubber stopper moves. Thinking back, once it was hard to suck the insulin out and I had to give the rubber stopper a push. It was just stuck. Other than that one time, it has not been a problem.
A pumper since 2001, sensitive to insulin and need to correct , have 1/2 u needles on hand...if I recall used same prior to pumping .I use BD Ultra-Fine 11, 31 gauge , length 8mm ...made in USA :)
http://catalog.bd.com/bdCat/viewProduct.doCustomer?productNumber=328440
Hi
I also draw up insulin into a syringe from a 3ml (pen) vial. I don't inject air, the stopper just advances. However, rather than just a dose, I draw up enough insulin for the day (say I draw up 10 units and leave it in the syringe). I recap the syringe and then carry it around in a syringe carrier (a plastic case that you put the loaded syringe in that holds the plunger in its open position) alongside my test kit. If my contin monitor shows I am high, (I try and stay below 95 and do a finger stick to check the contin monitor first) then I stick the syringe in my arm and can inject 1/2 unit quite accurately I feel (because the syringe has around 10 units in you gently squeeze the plunger down to 9.5 units and I feel most of that goes in (I would not be confident to try and load 0.5 units in a clean syringe as feel you might not get all that in - due to the dead space at the end of travel of the plunger???). I reckon my way I can get 1/4 units injection - but rarely try, if I need a correction I usually need a half unit (at least)).
I have on occassion carried a syringe around like this for perhaps 2 days (though ususally only do this for part of a day - say take enough with me to cover a day at work then fresh syringe when I get home) and the insulin does not seem to go off (I wondered if it would stick to the syringe or something but seems to work fine). I know this involves injecting then recapping the needle and using it again later but so far have never had an infection that I know of (I guess as it is just a subcut injection so less of a problem - like many, I reuse the same lancet for fingersticking for months without problem so reusing the syringe needle seems fine along similar lines). I know also that this way there is the risk of overinjecting - like trying to put in 1/2 unit then slipping and ooops 10units gone in! All I can say is this has not happened to me yet - tho on occasion I have given nearer 1 unit than 1/2 but seems not to make to much of a problem). To help not overdose, before injecting I squeeze the plunger so a tiny drop appears on the needle tip before injecting (cleans needle so insulin runs easily if you have not used it for a while which saves the plunger suddenly giving as you push and you injecting more than planned) and also, once needle inserted in my arm, I hold the plundger with my thumb and first 2 fingers (like holding a pencil) and use my ring and pinky fingers to hold the syringe barrel - like this you can get good control of the plunger to allow to move it the small 1/2 (or 1/4) unit distance (like the others say, I use syringes with 1/2 unit markings). If I inject in my stomach it is easier as can have one hand hold the syringe barrel and the other hand hold the plunger (again, left hand holds barrel with thumb abd 2 first fingers like a pencil and right hand holds plunger close to left hand in similar way allowing tiny movements of the plunger for accuracy of injection).
In summary I carry a few units of rapid (analogue) insulin around with me in a syringe so i can take small correction doses of 1/2 - 1 unit if required - a sort of "poor mans pump" (I don't use a pump so I guess these extra small doses are the equivalent of pump boluses??). The syringe seems to work fine for at least 24 hours and I can give pretty small dosee with it with seeming accuracy (certainly within the limits of accuracy of dosing anyway which Dr B says may vary by 30% even if injected at the same site on a different day). If you are really small or insulin sensitve (say a child?) you may need to consider diulution which would allow much greater accuracy for a half unit but otherwise I would not be too worried about being "exactly" half a unit given the inaccuracies that exist on adsorbtion that I just mentioned. Finally for meals I take human insulin (slower action hence for low carb meals). Again I will often load a syringe with 5-6 units if I am going out and take say 3 and 1/2 units (my usual dose for a steak and salad etc eating out) in the fashion described above. I quite like carrying syringes as my insulin vials stay safe at home in the fridge. I have a white carrier for human insulin and black for the rapid correction insulin and have not mixed them up - yet! ONce I get home I discard the remaining insulin and syringe (a unit or 2) tho, as I say I have kept a syringe for over 24 hrs and the contents still seem to work fine so may keep it til later in the evening if there is more left in it). Possibly this all sounds complex but it works for me (so well that I have still resisted a pump - tho the omnipod looks good I seem to manage with a few units of Human insulin for a meal and very occassional boluses of rapid - driven by the contin monitor) as above. Regards