Help with a new insulin pen

[worcesterwoman]

I am struggling with blood glucose readings and have now been changed from novomix30 to Lantus Solostar and Apidra Solostar along with Gluco rx needles. I find that the buttons on the pens are too hard to operate and I end up bleeding and sore. I have a swollen thumb joint from arthritis.

I was shown previously a nice pen that operated with a click, like a biro, and know that there must be some alternative to these push in types that 'un screw' as you deliver the insulin. I know that there are probably better needles that my nurse might allow me to go on.

Any recommendations for an easy pen to use, whether cartridge or pre-filled please?

 

[noblehead]

The Solostar pen is a bit clunky and can be hard to push, Sanofi also do the Clickstar pen which might be a better pen than the one your using. Not sure about pens for the Apidra but a Google search will throw up some suggestions.

A quick search, according to Netdoctor the ClikSTAR or Autopen 24 pens work with Apidra cartridges..

 

[cosmicpoppy]

Hi worcesterwoman, I too use Apidra & Lantus Solostar. I don't have a problem generally with the pens however I have had a couple of faulty ones. No matter how hard I pushed the end it would not dispense the insulin so I just binned it & used a new one. My needles are BD Microfine Ultra 4mm/32g pen needles & are tiny so very 'easy' to use, you may wish to try these.

 

[worcesterwoman]

The Solostar pen is a bit clunky and can be hard to push, Sanofi also do the Clickstar pen which might be a better pen than the one your using. Not sure about pens for the Apidra but a Google search will throw up some suggestions.

A quick search, according to Netdoctor the ClikSTAR or Autopen 24 pens work with Apidra cartridges..

Thanks Noblehead, that is really helpful.

 

[worcesterwoman]

Hi worcesterwoman, I too use Apidra & Lantus Solostar. I don't have a problem generally with the pens however I have had a couple of faulty ones. No matter how hard I pushed the end it would not dispense the insulin so I just binned it & used a new one. My needles are BD Microfine Ultra 4mm/32g pen needles & are tiny so very 'easy' to use, you may wish to try these.

Thanks cosmicpoppy, will mention these options to the nurse next week. I have little 'bend' in my thumb and hence no pressure to apply to the pen top.

 

[Daibell]

Hi. I was using BD Microfine 4mm/32G needles which were excellent. My surgery then changed to GlucoRX 4mm/31G needles which are just as good but cheaper. So, I think your problem is the pens not the needles. I assume you are using 4mm unless you have a thick fat layer? I use Novopens for their insulins. They also use the screw approach which an arthritic might find difficult but might be slightly better?

 

[Nyxks]

Prefilled pens might not be a good option for you, vials might be the better option, yes it means drawing up your own insulin from the vial but you can actually get better controlled amounts from the vial then you can from the pens (pens don't do .5 they do full increments so not always the best option for everyone anyways).

 

[worcesterwoman]

Hi. I was using BD Microfine 4mm/32G needles which were excellent. My surgery then changed to GlucoRX 4mm/31G needles which are just as good but cheaper. So, I think your problem is the pens not the needles. I assume you are using 4mm unless you have a thick fat layer? I use Novopens for their insulins. They also use the screw approach which an arthritic might find difficult but might be slightly better?

Well, I tried the needles again last night and it is clear to me that they struggle to enter my skin, and hurt when they do, and then when the needle is withdrawn it drags my skin up with it (ouch), and then I found a large puddle of insulin sitting on my skin... To my mind the needle is sticking to my skin and not sliding.in and out.
Will persevere until Tuesday when I see the nurse since it looks like I am responding better to Lantus than the Novomix as far as bg goes.

 

[gorillamark]

Well, I tried the needles again last night and it is clear to me that they struggle to enter my skin, and hurt when they do, and then when the needle is withdrawn it drags my skin up with it (ouch), and then I found a large puddle of insulin sitting on my skin... To my mind the needle is sticking to my skin and not sliding.in and out.
Will persevere until Tuesday when I see the nurse since it looks like I am responding better to Lantus than the Novomix as far as bg goes.

Where are you injecting?

 

[worcesterwoman]

Where are you injecting?

Leg for Lantus and tummy for Apidra.

 

[gorillamark]

Leg for Lantus and tummy for Apidra.

Odd - you shouldn't be having pain not with those needles. Discomfort sometimes but not pain. You're sticking them straight in? - IOW not at an angle? I think if I were you I'd inject in front of the nurse. If you're not used to it or haven't been shown how to do it properly it can be difficult to get right even with microfine needles. I'd also ask your nurse if you're using the right length of needle.

 

[gorillamark]

I'd better add that I no longer need to inject insulin (I stopped a few months ago) but I do remember vividly that sometimes an injection would go pear-shaped if I didn't do it just so. Which is why I think you should demonstrate your technique to the nurse.

 

[Jaylee]

Hi, although I don't have dexterity problems a myself.
The Clikstar pen maybe your answer..?
It has a relatively chunky dial, good dose readout which can be reset by a twist if overdialled & smooth effortless, non resistive insulin delivery action all summarised in a sturdy design..
Coupled with an easy twist to remove the cartridge casing.
There is also a no fuss ram reset on this device when removing the empty cartridge, simply point the extended ram virticle with the cartridge removed & it will drop back ready for a new cartridge...

Your DSN should let you look one over regarding suitability to your needs...?

 

[worcesterwoman]

Odd - you shouldn't be having pain not with those needles. Discomfort sometimes but not pain. You're sticking them straight in? - IOW not at an angle? I think if I were you I'd inject in front of the nurse. If you're not used to it or haven't been shown how to do it properly it can be difficult to get right even with microfine needles. I'd also ask your nurse if you're using the right length of needle.

I've been injecting for a couple of years or more, and have the odd blip with bleeds and pain, but the needles I used to have, novotwist, always come away smoothly and go in smoothly, unlike the gluco rx ones. I am on 5mm needles as I have a weight problem.

 

[worcesterwoman]

Hi, although I don't have dexterity problems a myself.
The Clikstar pen maybe your answer..?
It has a relatively chunky dial, good dose readout which can be reset by a twist if overdialled & smooth effortless, non resistive insulin delivery action all summarised in a sturdy design..
Coupled with an easy twist to remove the cartridge casing.
There is also a no fuss ram reset on this device when removing the empty cartridge, simply point the extended ram virticle with the cartridge removed & it will drop back ready for a new cartridge...

Your DSN should let you look one over regarding suitability to your needs...?

I think the nurse is doing her best, she complained that she didn't have much in the way of pens to show me as the reps were cutting down, and has helped with technique in the past. The Clikstar does look like a good option, just hope they will allow me to have one, even if I have to buy a second as a spare.

 

[gorillamark]

I've been injecting for a couple of years or more, and have the odd blip with bleeds and pain, but the needles I used to have, novotwist, always come away smoothly and go in smoothly, unlike the gluco rx ones. I am on 5mm needles as I have a weight problem.

Painfully familiar with those blips. Not familiar with those needles so can't comment. I found that 5mm BD Microfine worked very well for me so that blips were kept to a minimum. If you have a lot of fat to punch through you might need to inject elsewhere such upper arm, or you might need another needle. But it sounds to me as if you need to emphasise to your nurse that this is only an issue since you switched from novotwist to gluco rx. BD microfine are fairly cheap. So if funding is an issue they might be worth trying.

 

[noblehead]

Well, I tried the needles again last night and it is clear to me that they struggle to enter my skin, and hurt when they do, and then when the needle is withdrawn it drags my skin up with it (ouch), and then I found a large puddle of insulin sitting on my skin... To my mind the needle is sticking to my skin and not sliding.in and out.
Will persevere until Tuesday when I see the nurse since it looks like I am responding better to Lantus than the Novomix as far as bg goes.

BD have brought out a new 4mm needle called BD Micro-Fine Ultra which has Pentapoint Technology, my pharmacy changed me over to these new needles just recently and I have to say they do make a difference, didn't have many issues before but from a comfort point of view they are far superior.

BTW, when you inject into the skin you should count to 10 before withdrawing the needle, that way it gives the insulin time to disperse/absorb and you don't get that puddle of insulin when you pull the needle out, try it and see if it makes a difference.

 

[Jaylee]

I think the nurse is doing her best, she complained that she didn't have much in the way of pens to show me as the reps were cutting down, and has helped with technique in the past. The Clikstar does look like a good option, just hope they will allow me to have one, even if I have to buy a second as a spare.

I'm never ceased to be amazed why the DSNs don't retain what the reps hand out for "demo purposes" only.. Even if it's just training on a orange & checking "textbook" proficiency?
Anyone with dexterity issues can be identified & appropriate measures taken with the devices used...
It's just a matter of writing a prescription & getting the chemist to order in..

With the arthritis & associated problems.. Do you find changing the needle on the pen a fiddle..?
I'm wondering if the part of the needle that penetrates the "membrane" on the cartridge has warped causing restriction in insulin delivery. The pressure exerted on the button by weakend thumb may cause shake? Thus injection issues..
Are you able to "pinch up" the skin on the injection site??

 

[worcesterwoman]

BD have brought out a new 4mm needle called BD Micro-Fine Ultra which has Pentapoint Technology, my pharmacy changed me over to these new needles just recently and I have to say they do make a difference, didn't have many issues before but from a comfort point of view they are far superior.

BTW, when you inject into the skin you should count to 10 before withdrawing the needle, that way it gives the insulin time to disperse/absorb and you don't get that puddle of insulin when you pull the needle out, try it and see if it makes a difference.

Am counting to ten, like I did with the novotwist needles, and it's like the skin graps the needle with gluco rx, there is no sliding in and out. To all intents it feels like I am using a blunt knitting needle.

 

[worcesterwoman]

I'm never ceased to be amazed why the DSNs don't retain what the reps hand out for "demo purposes" only.. Even if it's just training on a orange & checking "textbook" proficiency?
Anyone with dexterity issues can be identified & appropriate measures taken with the devices used...
It's just a matter of writing a prescription & getting the chemist to order in..

With the arthritis & associated problems.. Do you find changing the needle on the pen a fiddle..?
I'm wondering if the part of the needle that penetrates the "membrane" on the cartridge has warped causing restriction in insulin delivery. The pressure exerted on the button by weakend thumb may cause shake? Thus injection issues..
Are you able to "pinch up" the skin on the injection site??

I have now persuaded myself that my skin must be not yielding to the needle, for whatever reason, and I do have a better record using novotwist, so will ask for a Clikstar on tuesday and something like th BD micro fine needles.