I just had an experience that was a little perplexing and thought I'd reach out for some advice.
I went to take my nightly dose of Levemir (16U via my pen) - I'm good about rotating my injection points and log where I inject every time, and I am careful to count to (at the very least) 10 before removing the needle so that I don't lose insulin when injecting. However, tonight I saw a LOT of insulin drip out from the needle when I removed it and it even looked like some might have seeped out of the injection point (although I can't be sure if it was just what came out of the needle). There was a little bump under my skin after I took my shot, which I have never seen before, as well.
As such, I decided to try another shot of 4 units - the amount of insulin that dripped out was significant and I figured 4U was a conservative estimate. However, the same thing happened - upon pulling the needle out of my skin, there was approximately the same amount of insulin dripping.
I repeated the process again - in a different spot - with 2 units and had the same result - it looked like the entire 2 units dripped out of the needle when I removed it. I pushed on the plunger (without dialing up another dose) to see if it was just leaking insulin, but it didn't seem to be the case.
I'm not going to take any more tonight. I just tested and my BG is at 101 so I ate about 5.5 g cho just to make sure I don't get too low at night and will be waking up to test in a few hours to see where I am.
Has anyone had a similar experience? My bolus before dinner this evening went in fine and I'm wondering if this might be an issue with the pen since it happened on three different spots - but this is a pen I've been using for a couple of weeks and have had no issues so far. I've read about hard spots forming under the skin if one uses the same injection point, but I don't think that's the case (been diagnosed around 2 months and rotate my injection spots).
Is this a common issue with pens/needles and, if so, are there some common causes?
Check if there might be a bigger than normal air bubble in the cartridge. Has happened to me and then I had insulin dripping out after removing the needle. If that is the case get rid of most of the air by holding the pen in a way that the bubble is at the top of the cartridge right under the needle and prime the pen a few times so that the air gets pushed out of the cartridge. Having a little bump under the skin sometimes happens, not too unusual at least for me. I tend to massage the spot a bit until the bump more or less disappears. I think it happens when you inject your insulin right under your skin instead of reaching the fat tissue with the needle. I would say if this is not something that happens to you all the time it is not a big problem.
Thanks for the input - my BS seemed pretty stable through the night - 101 before bed at 10:51, I had about 5.5 carbs after that - woke up at 2:30 and was at 106, ate a glucose tab (4g) to be safe, and woke up at 4:33 at 134.
When I actually got up this morning at 7:51 I was at 102 and just tested at 10:40 am at 95 - so things seem to be stable, which is a relief.
If it happens again, I might switch out pens and see if that makes a difference.
Hi Till - the bubble does seem to be larger than normal - so when I take my Levemir tonight, I'm going to prime out the air first - the only thing I'm curious about is if the issue continues during the day as I bolus with Humalog -we'll see!
I've found the only way I've had luck getting air bubbles out is to pressurize the pen a little-- pump two or so units and hold the pen vertical so that the air bubble is at the top-- keep pressure on the plunger while you slowly insert needle onto pen. If I put needle in first then try to prime, the interior needle that is actually in the pen is down below the bubbles...
This is a good advice. I actually have problems getting the air out of my new novo pen echo which I use for my levemir. Never had problems getting the air out of my humapen. I will try that the next time.
I have this happen to me quite often actually. Now I inject slowly. If I feel any resistance that the insulin is not going in properly, I immediately pull out the needle from my injection site. Usually insulin will squirt out the top. Then I dial up the dose and start again. I always figured it was a plug within my skin, not anything to do with the needle itself. When I re-inject in a new site, it tends to be fine.
Any problems since? If your pens are free (as mine are), you might want to get new ones, just in case the pens are the problem. It couldn't hurt anyway. Another option is to inject in new sites where you haven't injected before.
Once or twice I've felt resistance after the fourth or fifth unit of my Basal, so I just change the angle of the needle slightly and it usually flows better after that - I give a bit of a longer count before removing the needle, too. I haven't had to pull the needle out completely and start over yet.
Also, priming out some of the air bubbles in my Basal seems to help - for some reason my Levemir pen gets bigger air bubbles than my Humalog (not sure if it's a brand issue or that my Levemir doses are larger (16U at a single shot vs. 2 or 3 per meal of Humalog, depending on food).
I have noticed, however, that there is a spot on the left side of my abdomen (about 3:00 from my belly button) where I will get irritation if I inject. It gets red and itchy initially and then swells up like a bee sting - it's happened twice so I now avoid that spot, and hasn't occurred anywhere else. I'm not sure if I just have less body fat there and am hitting a muscle or what the case is - but, again, I'm avoiding that spot and haven't seen that happen since.
I’ve been thinking about the split approach, but mainly as an option down the line.
My post meal (2-hr) readings are generally at or around 100, sometimes a bit lower, and (less frequently) a bit higher and my BG is generally stable between meals, so I’m hesitant to change things too much just yet. If I see that my numbers trend higher I may try the split dose to help avoid my basal from wearing off too much - TLAP says that the “lifespan” of my Levemir dose is about 24 hrs with a taper in the last two, but I haven’t noticed that as a big factor - yet.
I think I’m also worried that I’ll forget my morning dose if I split it - I’ve set my basal dose time for 10:30 pm so that I’m at home and not distracted by work, etc. - I also have an alarm set on my phone to remind me every night.
I’ll be interested to see how things change over time, but it’s definitely a thought that’s crossed my mind.
