I'm currently in a honeymoon period of type 1. Therefore I'm taking very small doses of both basal and bolus insulin. Usually I am only injecting 3 units of novolog with each meal (20:1 carb ratio) Looking at the design of this pen-- it seems obvious to me that the first and last unit of a dose of any size are fairly imprecise. Mid dose-units should be fairly accurate-- but if you are only taking 3 units at a time, and the first and last unit are prone to being iprecise, your doses could be pretty inconsistent, particularly with small doses. Have any of you had this experience / concern? Are syringes better in this regard? Any suggestions?
I had a lot of trouble with Pens and my CDE recommended I try a pen with half unit dosing like the Novolog Jr. I initially took 4u Lantus and 1-5u novolog with meals my I:C ratio was 1:20. Ultimately, I found it nearly impossible to get the dosing just right and often found myself high or low. I switched to a pump and am very glad I did.
For my 3 years old daughter I use half unit pens: novolog junior (for novolog and levemir) and luxura hd (for humalog and lantus): i find their dosing accurate enough.
But if you need super precision and don't want/need a micro pump look at this (I think) wonderful pen: Pendiq (link). It costs 170 euro plus shipping (online shop).
It can work with humalog/lantus, doses 0,1U from 0,5U up, it's electonic controlled and "remembers" all data you can download later to PC.
Here a video:
To exactly deliver one unit with a pen is problematic but 2 or 3 units should work perfectly - at least with a NovoPen. I really recommend the NovoPen Echo with 1/2 unit delivery and memory (very important for the basal).
169 Euro is about $223 US, just to let you all know. I'm not sure if this is available in the states.
It isn't approved, but it works: you can put an apidra cartridge into a Luxura HD pen. Luxura is for humalog, but it has the same size as apidra. Apidra is only a little "longer" so you have to put on an open needle while closing your pen the first time just to let some insulin spring out.
So you have half units with apidra.
We use the 1/2 unit pens with my daughter as well. At supper, she gets only 1/2u (unless correcting a high). Most times this is enough to cover her carbs and she is in range at bedtime, but there have been a few times she is surprisingly high at bed without explaination. When I brought the issue up with our D team saying it seems like she didn't even get any insulin, the answer I got was "your right, she didn't". Apparently, the manufacturers of the pen cannot "gaurantee the accuracy until 1 unit dosing is reached". It actually has this disclaimer in the leaflet included with the pen! (its a Lilly Jr pen) So I guess my answer would be that, yes, then first unit (or 1/2u when using those pens)has spotty accuracy when only giving that first unit, but once you reach your second "click" you should have precision with dosing.
Does this work with Novolog too?
No, but novolog has his own pens with half units, they are novopen junior, echo and there should be novopen demi too with half units.
The same luxura hd works with lantus.
Syringes have errors too, the first unit is always off, lines are too big to be precise and there is a parallax error too.
I find half unit pens more constant in behaviour.
BD makes 1/2 unit insulin syringes, and I'm told that they are available in some other brands as well. You can actually remove insulin from a pen with a syringe, being careful to prime the next time you use the pen with a pen needle.
I think the first unit is also off on pens and never will bother with a single unit injection. It just seems like a crapshoot.
C O N C L U S I O N S— Pen devices are more accurate than insulin syringes in measuring out
insulin at low insulin doses. The accuracy of insulin syringes improves when higher doses of
regular insulin are measured out and becomes comparable to pen devices.
Yep, not available in the states. I would highly recommend Humolog luxura hd pen, although my insurance (United Health Care) does not cover it.
I have an Echo .It keeps track of amount used and time of injection.Also measures in half units but only up to 35 units. It is made by Nova.