Should old insulin pen be replaced

[Gloucestergirl]

Hi

I am new here and hope someone can give me some advice. I have had diabetes for 17 years and have been on insulin for around 12 of those years. I have had two or three pens for the quick acting insulin and the present pen I use must be five or more years old at least. I was told that glucose meters should be replaced every three years but I wondered if the same thing applied to insulin pens. I've tried finding information on how long an insulin pen lasts before it should be replaced but I haven't found anything yet. I use the pen three times a day and wonder sometimes if it is giving the right dose.

My local area health authority have decided to make everyone use a certain meter, because the test strips are cheaper and they think they will be saving money but there are so many errors with this new meter that I am using twice as many test strips as I was before which defeats the object of the change. The meter is a Glucolab and I wonder if anyone has also had trouble with it.

 

[Daibell]

Hi. I'm not aware that you need to replace a meter every three years? I've had mine for about 8 years now. I've replaced the batteries once and used test solution once or twice to check calibration. My meter supplier (Lifescan) provided all these free.

 

[ronialive]

Hi
There is a way to check your pen delivers the right amount if you read the instructions. if you hold the insulin needle cap and squirrt 20 units into it it should reach the top of the needle section. if it doesnt then the wrong amount is being dleivere.d My doctros used to replace mine yearly.They never lasted that long before the numbers rubbed off.

 

[noblehead]

I think the advice is to change insulin pens every 2-3 years or before if faulty (obviously). Just recently I noticed my postprandial bg was starting to creep up slightly for no reason whatsoever, after ruling out insulin and site problems etc I decided to change the pen, tbh I couldn't remember when I'd last changed it so went ahead and my bg returned to normal, I suppose anything mechanical will eventually wear out and become less reliable.

There's been quite a few posts of late where members are saying their gp surgery's are changing to one meter only, this is due to costs as your aware and I'm not sure if there's much you can do, however if your experiencing errors when testing then you need to tell your gp about these problems, they might say to ring the manufacturer first for help so it might be a good idea to do this, with the exception of my first meter I usually change meters every 2-3 years when a new model becomes available.

 

[iHs]

Hi
There is a way to check your pen delivers the right amount if you read the instructions. if you hold the insulin needle cap and squirrt 20 units into it it should reach the top of the needle section. if it doesnt then the wrong amount is being dleivere.d My doctros used to replace mine yearly.They never lasted that long before the numbers rubbed off.

Hi

What length insulin pen needle are you to referring to here.... pen needles come in 4mm, 5mm, 6mm, 8mm and 10 and 12mm? 20 units insulin squirted into a needle cap is going to come up at various heights inside a needle cover depending on what length of needle is being used....or do you mean the clear plastic funnel part?

 

[Gloucestergirl]

Thank you all for your replies. I was told by a diabetic nurse that meters should be changed every three years and was promptly given another one which I was so impressed with I bought a small version which took the same testing strips to keep in my handbag (Accu-Chek Aviva and Accu-Chek Nano) I got on really well with those meters but the powers that be have recently decided to save money by putting everyone onto either a Glucolab or Wavesense and it looks like I might have drawn the short straw. Only this morning I checked my blood with the new meter and the old one and the old meter showed 6.0 and the new one 5.1, not really too much of a problem but if the new one showed, say, 3.5 and I corrected the hypo when the reading was actually 4.5 it would screw up my sugar levels when it wasn't necessary. I have no faith in this meter whatsoever. It doesn't supply free batteries and you have to pay for the test solution and I even wonder if I would be able to get any backup from the company if the meter was faulty because the Warranty form to fill in asked about the purchase date etc. and I wouldn't know that as I didn't purchase it myself.

Regarding the insulin pen. When I was first put onto insulin it was just Lantus, then I was put onto various quick acting insulins as well and was messed about horribly at times by various diabetic nurses, either being told to stop or adjust my doses 2 units at a time which would be far too much for me. I am very sensitive to insulin as just a tiny amount can make a big difference so I was put onto a demi pen that gave half unit doses and my usual dose is anything between 4 units and 6 units per meal. As I said before it was at least five or more years ago since I had the pen and there has been no mention whatsoever about how long to keep a pen before getting a new one. I know about using the cap to measure out the dose but I hadn't thought about the fact that it might be different according to the length of the needle. I use the shortest ones (4mm) yet a friend of mine uses 12mm but perhaps the needle caps are a standard length as there is a lot of room left at the end of the inner cap on my needles. I've just measured the part of the cap used to check the dose and it is 15mm so perhaps they are a standard length.

I think I shall make an appointment to see the diabetic nurse and perhaps she can check the meter. I shall certainly tell her about all the error messages that I get which means having to test again so using twice as many test strips as before - a real cost cutting disaster!

 

[AMBrennan]

No offence, but did you actually read the manual - just asking because the limited lifetime is explicitly stated for both Humapen (3 years) and Clickstar (4 years).

 

[anna29]

Hello Glouchestergirl.

I use both the cartridge Autopen and have a demi3 half unit pen too .
Use 5mm needles .

Am from the northwest and was told by my nurse to use my surgery to request another if I ever need to .
The usual warranty with a pen is 3 years from both roche and owen munfred .

I do have 2 'spare' pens my GP's have supplied me with , in case one was to break at a weekend or if on a holiday .

Think it would be best to discuss all of this with your diabetic nurse as soon as is possible ...
To be on the safest side of things - as you will need both your meter and insulin pen both working okay .

Just a thought with your meter readings - have you ever tried to correct and clear , using the control solution?
Provided with the meters - these will need to be in date too and not expired .
When my accu-check played a bit hit n miss with error readings - I cleared it using the control solution .
It stopped with any error readings - after running the control solution through a testing strip ...
Just an extra thought for you here .

Anna.

 

[Gloucestergirl]

Thank you AMBrennan and anna29. Regarding whether I had looked at the manual when I was given the pen, that, as I said, was at least five or more years ago. I have found it again and it does state that Novo Nordisk will replace a Novopen if it is returned to "your supplier" within three years of getting it so I wonder what happens after three years, I shall ask my diabetic nurse.

As for the meter, I'm afraid that the days of getting free batteries for life and free control solution have gone as they now all have to be paid for as they are not supplied with my new meter. I could ask the diabetic nurse if she has any solution first but will get myself some anyway. The most annoying thing about the meter is that even when I have used a new test strip straight out of the tub it comes up with an error message that says it's a wet or used strip so I have to test again. My friend has been forced to have the same meter by her doctor and she is getting exactly the same error messages as me so perhaps it's a unique "feature" of this pen. I have heard that there have been lots of complaints about this Glucolab meter so I am sure we are not the only ones who are having problems with it. Anyway, I shall make an appointment to see my diabetic nurse and take it from there.

 

[donnellysdogs]

All meters give different readings.. Best stick to one if possible
I used to feel same as you.. If low or even high on one meter and the other one says different.. You could be mistreating yourself for supised hypers and hypo's...
However, the manufacturers of these machines are allowed such relatively huge error rates.... That it is best to keep to one machine that you trust !!!- lol considering the rest of ur message...

Error messages... Report them on the mhra website for faulty equipment... Tell your gp, dsn everybody... In fact it actually bothers me more that hcps themselves dont take note of what their patients tell them and report equipment failures to mhra...perhaps then the nhs wouldnt be wasting so much money having to provide people with extra strips because of all the failed ones...
Makes me mad...

I have myself had to report my cgm to the mhra, for telling me I was low constantly... When my blood tests were saying I was between 5 and 7.... I tried telling my hcp's, the manufacturers... But no satisfaction from either.. So I felt that this was not tolerable standards for orher prospective cgm users in the future.. (i was on version 1 of this cgm, they are now bringing out version 2- so they may well know version 1 had faults!!)

I think we will always have differnt readings on different meters because of the allowances in accuracy/errors that manufacturers are allowed.. However .. Error messages that you mention I believe should be reported in addition to the MHRA website for equipment failure.. Its the only way to get manufacturers to improve their quality and accuracy of their products....

 

[toby1973]

In regards to the pre-filled insulin pens, the hospital consultant, DNS, GP, Practice Nurse and Pharmacist all say that any thing left in a insulin pen should be discaded with after 28 days and start a new one.

 

[Gloucestergirl]

Thank you for the latest replies. I have had a look on the mhra website and think I will go down that road anyway, even if I speak to my diabetic nurse which I haven't done yet. Actually, I hadn't even heard of mhra and had to look it up but I shall tell my friend who has been having the same problems with her meter. I know it's probably best not to compare two different meters but I have had some really weird results with the Glucolab so feel I have to check with the other one. A couple of days ago I wrote down all my Glucolab results in a list by reading the results off the meter even though I write down pre-meal readings into a book. One day I had been feeling a bit hypo and did a test with the new meter. I don't remember doing it but it appears I tested three times and got the following results:- 4.15pm 7.2 4.15pm 8.4 4.17pm 3.3. Yes, that's two readings within the same minute, same finger, same blood, then another reading two minutes later 3.3!! I checked it with my other meter and it said I was 3.4. Is it any wonder that I don't trust this meter? By the time I went to bed my BS was 19.9, well, the meter said it was anyway. I am going to order some control solution from the Glucolab website which will tell me whether it's the meter or the testing sticks that are causing errors.

As for the insulin pen, I was turning out some drawers that contained a few old meters and needles etc. when I found a Novopen 3 Demi I didn't remember I had. I think it was one I was given , used for a few weeks and then I was changed onto a different insulin and another pen. I have been using the pen for three days and it certainly feels better when I dial up the doses, not so "loose" so maybe that will help with my sugar levels as well as they have been rather erratic lately. With the insulin, I have worked out how many days one tube of insulin will last and it's 12 days for Novorapid and 14 days for the Lantus so I never have insulin out of the fridge for more than 28 days. Hopefully I have sorted out the pen, it's just the meter I have to deal with now. Thanks gain.

 

[donnellysdogs]

I have actually dipped hypo, very.. Very quickly.. Within minutes from 7 to 3 ish in levels..

I know it has also happened at xmas.. And I know the cause for mine.. Mine was my stupidity to be honest.

Did a test ... On a pump so corrected as blood said I was 15+... literally within 5 mins I was super duper hypo.. My hands had some remnants of food on them... Now because it was Christmas I just believed the high reading.. Wheras a high like that I would normally double check...

But insulin doesnt work immediately on entering the body...so I was genuinely low... And then had overdosed more insulin to act!!!!

Make sure now my hands are washed if poss...

In addition, when using the cgm which gives readings every minute, I can seeiously see them shifting downhill fast on occasions. That is why on my pump if I have a higher reading I will mot use an additional tbr to rush it to drop down quickly...(it should return to normal within 5 hrs).

If there is any 'crossover' in peak worming times of any of your insulins working together, in all honesty I would say it is very possible that your meter could give readings like that.

Unfortunately, meters are allowed error rates as well .. The same as garage petrol pumps... You think you paying £1.28 a litre for your petrol.. But the pumps are allowed by law to give more or less.. According to how the garage owner wants them set up...AND wear and tear... Useless advice for today.... Fill your car up slowly at the forecourt as you will get more fuel.... BUT you will not get a full litre of petrol when buying it... Never.. Same with our meters.. Do allow for readings to be a guide.. Not precision...

The cgm I have has also shown me how quickly my blood readings can go up or down.

I dont actually like the sound of your glucolab meter tho in all honesty. I think I have had accuchek roche ones for the majority of my D.. But know I also used to get variances between 2 meters from sdme company, same blood etc.. Know I did a posting on it years ago as it was my new pump meter and my old meter.. And I didnt know how they could be so different.

Personally I know the MHRA took great notice of my reporting the flexlink plus sets as faulty, and in end they were withdrawn. But it is only through reporting side effects of equipment... Or mainly drugs to the MHRA that these companies will 1) put warnings on the leaflets!!!- as in Statins for finally changing their warnings or 2) improve the side effects of the drugs or 3) if they are dangerous .. Be forced to remove the drug/ equipment from usage....