I am using the All Star insluin pen by Sanofi. What I have realized is that the amount of dosage that the pen releases is not consistent. For example, if I dial 2 units, sometimes the amount of insulin that gets dispersed is more and at other times it is less. I have tested it and noticed this several times. Today my dd had a low because of this it seems ! What has your experience been around this?
Note: I am anyways switching to Humapen Luxura HD by the end of this week. Anyone who had first hand experience using this one?
Yes, I generally prim it on each needle change and whenever I change the cartridge. Sometimes I have a tendency to test is randomly before administering it.
It is really weird - sometimes when I dial 2 units and press the trigger a gush of insulin comes out. And, at other times I see drops (around 3-4). I am just so confused!
The All Star is a reusable pen made in India intended for emerging markets. In the case of the All Star, the instructions call “priming” a “safety test.” After you put on the pen tip, dial in a 2 units dose. Turn the pen so that the pen is vertical with the needle at the top. Flick the pen on the side of the cartridge to move any bubbles to the top of the pen and then inject the 2 units into the air. If you don’t observe insulin coming out, repeat. Dial in 2 units, flick the side of the pen and inject. When starting a new cartridge you may have to do this process several times. If you don’t do this properly an injection of 2 units will be highly variable and may actually be “nothing.”
Yeah, I am doing that. The only difference is that I tend to do this procedure very frequently and sometimes I hold the pen horizontally (could that be a problem?). Also, the problem is that I notice a difference in the amount that gets dispersed. Sometimes the insulin comes out like a gush of liquid and sometimes it is a few drops. Don’t know if that is causing variations in my daughter’s BGs post meals?!
You should do this every time and it is vital that you hold the pen vertical so air bubbles go to the top of the pen, otherwise air bubbles can be present in your injection.
You can do a test to see if you are getting consistent doses of insulin. Take a piece of tissue and then very carefully go through the process to do the “priming”/“safety test” and then inject 2 units onto the tissue. Then do this for a couple of times. The wet spot from the 2 units should basically be the same size. If the wet spots are different sizes then you have a problem with the pen.
I’ve used this – solid action and able to deliver half unit increments, I liked it a lot and never had a problem. My insurer forced me to switch from Humalog to another insulin this year and it seems only Humalog comes in the cartridges that fit the Luxura.
I’ve written this before and no one else seems interested; anyway… I use BD 1/2 unit syringes to extract insulin from my pens. Always accurate and it’s not that much more trouble to carry syringes rather than pen needles. I always use the syringes twice, which cuts down on the number to carry with me when I’m away from home (BD does recommend using them only once).
@MarieB. I use the Apidra SoloStar and Levemir Flex Touch. I simply stick the syringe needle into the pen and withdraw the amount of insulin that I want, then inject myself.
@Priya1 - Yes same priming method as for other pens. In normal use I find that a single unit is usually sufficient to prime. @Trudy1 - I can appreciate the advantage of this for getting half unit increments when the pen won’t do it, good suggestion. Though over time it seems this would produce a fair bit more sharps/plastic waste than with the pen needles. Part of the reason I liked the Luxura pen was that, in addition to the half unit capability, only the cartidge, not the whole pen is disposable. If you’re doing this every time, any reason not to get the insulin in vials instead?
@truenorth. There is always some waste–I find that I waste less insulin with pens since there is more insulin in a vial than a pen, and I don’t use much insulin daily. I’m a Type 1 and on the small side. A nice second benefit is that pens are easier for me to carry around than vials since pens fit easily into pockets, but it is not having to toss expired insulin left in a vial that caused me to switch from vials to pens.
One thing that had occurred to me a month ago is that the syringes I have are too large. Even those on the pump need syringes (for when an infusion set goes bad). I take about 37-40 units a day. But I have 0.5mL syringes (holds 50 units). What I should be using is a .3mL syringe. When I DO need to take injections, I will be able to give myself a half unit more precisely.
I would imagine that five and six-year-old children sometimes need half a unit. I would talk to your doctor about insulin pens that can dose at half-unit increments. If you CAN’T get a pen that’s accurate enough, you may have to go with a syringe. Be very insistent that you need to be able to give small, accurate doses to your child. Young girls (and boys) are very sensitive to insulin if for no other reason that they’re small and don’t need anywhere close to as much as adults do!
However, older kids and teens need total daily doses of insulin sufficient to kill a small herd of horses once those growth and puberty hormones start kicking in! My 13-year old weighs 120 pounds and lately needs upwards of 85 units daily.
I am getting the Humapen on Saturday that can dose in increments of 0.5 units. Hopefully, that will do some good. My daughter is currently requiring from no to really small dosages of insulin. She started to hypo post dinner around 2 weeks back (with as little as 1 unit of insulin on board). Now, this trend has shifted to lunch time. She does not need fast acting insulin post breakfast. Also, she is completely off basal since last 2 weeks and her fasting numbers are great too (range from 80-120). Does this sound like she in honeymoon?
Ugh! This site gets messed up if you somehow get logged out! Honeymoons are different for everyone. All you really need to remember is to treat what you get. Her needs are going to change. As long as you can figure out you need to change her regimen, you’ll be fine. Do you have an endocrinologist/doctor who you are able to talk to (or a very trusted educator) fairly easily? They can help you navigate in this early going.
I know this sounds incredible right now, but it won’t be long until YOU know more about your daughter’s diabetes than anyone else. Once you learn how to learn what you need, you will be astonished at how much clarity you will have when helping her navigate Type 1.
! What has your experience been around this?