Faulty pen?

[DiabetusDeletus]

I've noticed that sometimes my Novorapid pens are faulty and don't bring me down to the correct sugar level? I'm a pretty newly diagnosed T1D and I'm at a loss here. I know I injected the correct amount if not a little too much and yet I'm stuck in a hyper HOURS after food. any advice would be really nice

 

[Deleted member 527103]

Do you have single use or reusable pens?
As you mentioned “penS” I assume you are using single use pens. If this is the case, I recommend requesting reusable pens. Not only do they produce less waste and the cartridges take up less space in your fridge, the reusable pens are more robust.
If you are suspicious about a pen, you can do a quick check by squirting 20 units into the outer cover of a needle. 20 units should fill the narrow part of the lid.

However, I would also recommend looking for trends when you think your insulin is not working as there is far more than insulin and food which affects your BG. For example, is this more likely to happen in the morning? We are often more insulin resistant in the morning so need a different insulin to carb ratio. Or does it happen when you are stressed or unwell? Or does it happen when you eat meals higher in carbs? Or when your starting BG is higher?
And does you BG finally return without a correction after four or five hours? NovoRapid lasts for this long. If your BG stays high fir longer than you want but return in range, you will probably need to prebolus earlier so the peak of your carb digestion matches the peak of your insulin profile.
In other words, your insulin may well be working (faulty pens are rare) but there is more going on to cause the longer hyper.

 

[DiabetusDeletus]

Do you have single use or reusable pens?
As you mentioned “penS” I assume you are using single use pens. If this is the case, I recommend requesting reusable pens. Not only do they produce less waste and the cartridges take up less space in your fridge, the reusable pens are more robust.
If you are suspicious about a pen, you can do a quick check by squirting 20 units into the outer cover of a needle. 20 units should fill the narrow part of the lid.

However, I would also recommend looking for trends when you think your insulin is not working as there is far more than insulin and food which affects your BG. For example, is this more likely to happen in the morning? We are often more insulin resistant in the morning so need a different insulin to carb ratio. Or does it happen when you are stressed or unwell? Or does it happen when you eat meals higher in carbs? Or when your starting BG is higher?
And does you BG finally return without a correction after four or five hours? NovoRapid lasts for this long. If your BG stays high fir longer than you want but return in range, you will probably need to prebolus earlier so the peak of your carb digestion matches the peak of your insulin profile.
In other words, your insulin may well be working (faulty pens are rare) but there is more going on to cause the longer hyper.

It might be bigger meals like you mentioned, this was a pretty carb heavy meal and it's rare I ever take as many units as I did. I'm using single use pens at the moment but I have a clinic meeting tomorrow and I'll bring it up. I'm also unwell and while it might be a bit TMI due that time of the month (I'm a woman). I'll keep watch of them and take these points into consideration. thank you <3

 

[Rokaab]

It might be bigger meals like you mentioned, this was a pretty carb heavy meal and it's rare I ever take as many units as I did. I'm using single use pens at the moment but I have a clinic meeting tomorrow and I'll bring it up. I'm also unwell and while it might be a bit TMI due that time of the month (I'm a woman). I'll keep watch of them and take these points into consideration. thank you <3

Yeah illness and time of the month can indeed affect your blood sugar levels I'm afraid - illness always sends my sugars up
Unfortunately its not just as simple as so many units of insulin covers so many carbs all the time

 

[MommaE]

As others have said lots of potential reasons for being high longer than expected. When I’m in that situation I’ve found the most efficient thing to do is a brisk walk rather than more insulin. Doesn’t have to be long either, just get moving for a bit. You might, with hindsight come up with a reason for it which can help you plan better next time, you might not, just the way it seems to go with diabetes.
Sorry for the bold type, not shouting, it means only that I don’t know how I did it nor how to undo it!

 

[EllieM]

Or when your starting BG is higher?

Certainly the same for me. Once my bg is high my insulin seems to act much slowly and less effectively than if it's in normal range.

But as a new T1 @DiabetusDeletus may find find that you still have a fair amount of tweaking of insulin ratios to do. Mine vary a lot with how much exercise I've been doing, and by time of day.

Hopefully your team have discussed correction doses with you?

 

[searley]

You say ‘bring you down to correct’

For me staying in control is much easier than correcting…. For example I had too much to eat yesterday at midnight my bg was 19mmol. I took 15u at that time now at 5am I’m still at 13….

Had I had the right insulin in advance to keep my bg lower then it wouldn’t be high now…. It’s a difficult one to understand but correcting always seems harder

 

[Tony337]

As others have said lots of potential reasons for being high longer than expected. When I’m in that situation I’ve found the most efficient thing to do is a brisk walk rather than more insulin. Doesn’t have to be long either, just get moving for a bit. You might, with hindsight come up with a reason for it which can help you plan better next time, you might not, just the way it seems to go with diabetes.
Sorry for the bold type, not shouting, it means only that I don’t know how I did it nor how to undo it!

I couldn't agree more in relation to walking to get the insulin working more effectively.
I've often been poo ppod by people telling me walking sends their levels up!

It works wonders for me.

Lots of food and lots of insulin sloshing about my body often confuses my libre and it tells me to ****** off for ten minutes!
I do and that usually means a stroll!

30 minutes later and all is well.

Happy days

Tony

 

[DiabetusDeletus]

Thanks all who've replied to this! I'm glad to report that I've completed my DAFNE now and feel a lot more confident in correction doses and dose changes on the fly. I'm now on reusable pens which seem so much better, excited about being able to bedazzle my diabetes a little more (everything is better when it's in pretty colours). I generally think it was the time in my cycle causing it and I'll take all of your recommendations into consideration! that brisk walk idea is perfect, I've noticed my sugars tend to drop if I walk anywhere!

 

[Emma t]

Has anyone ever had pens run out quicker than they should? My son takes approx 26 units a day of nova rapid. So a (300) pen should last around 10 days but recently they have only been lasting 5 days! I have been keeping a record of how much he is using and it doesn't correspond, what is happening? He definitely isn't overdosing that much as he would be constantly low and he is not. His dr just says its not possible but something is happening and I can not work it out and its driving me mad!!! Pen is kept in the fridge between uses or in a cold pack. Help!!!

 

[EllieM]

Has anyone ever had pens run out quicker than they should? My son takes approx 26 units a day of nova rapid. So a (300) pen should last around 10 days but recently they have only been lasting 5 days! I have been keeping a record of how much he is using and it doesn't correspond, what is happening? He definitely isn't overdosing that much as he would be constantly low and he is not. His dr just says its not possible but something is happening and I can not work it out and its driving me mad!!! Pen is kept in the fridge between uses or in a cold pack. Help!!!

Has he changed the way he uses the pen? If he changed the needle every injection and did an airshot that could be an extra 10 units a day???? (OK, clutching at straws here.)

 

[Emma t]

Has he changed the way he uses the pen? If he changed the needle every injection and did an airshot that could be an extra 10 units a day???? (OK, clutching at straws here.)

He uses a new needle every time but only does an air shot when he starts a new pen so not wasting it like that either. I have asked him if he's doing extra shots at school etc but even if he was it wouldn't equate to what we are losing. He's been using the pens the same way for the last three years but it's only in the last month or so that we seemed to be running out before his next prescription was due. At first I thought we must have lost a pen somewhere, had the fridge stripped out incase it had fallen down the back etc. But since I've been meticulously noting down how many units he's using its just crazy that one minute it looks like there is 200 units the next time you use it looks like it's gone to 175 after having only used 6 or 7 units. It just doesn't make sense. And I'm driving my son mad as he thinks I'm micromanaging him (teenager) !!

 

[EllieM]

OK, what do the empty cartrdges look like when you pull them from the pen? Are they actually ... empty?

 

[Hopeful34]

Just a few random thoughts to try to help.
Could your son be eating lots of very high carb snacks during the day, which need a lot of insulin to cover? I know you've already asked him, but teenagers often want to eat the same as their peers.
Are your sons blood sugar readings around where they normally are, with the usual rise after meals etc?
Possibly faulty pens, as in not dispensing the correct amount of insulin.
Any possibility your son isn't actually giving some doses of insulin, and just randomly firing some into the air, thereby going through lots more.

 

[Emma t]

He uses disposable preloaded pens the dial won't click round when it empty. This is a new pen

Just a few random thoughts to try to help.
Could your son be eating lots of very high carb snacks during the day, which need a lot of insulin to cover? I know you've already asked him, but teenagers often want to eat the same as their peers.
Are your sons blood sugar readings around where they normally are, with the usual rise after meals etc?
Possibly faulty pens, as in not dispensing the correct amount of insulin.
Any possibility your son isn't actually giving some doses of insulin, and just randomly firing some into the air, thereby going through lots more.

Hi, I'm pretty sure he isn't doing extra to cover extra food he's a sensible kid and he was at home over Easter so kept a close eye and still going through the insulin too fast. Also his numbers are normal. The only thing I've noticed is if you dial up the units and then press the end without a needle on, it depresses and goes back to zero and when you put the needle in insulin comes out (a drop) without pressing anything. I'm wondering if some how it's getting turned and pressed in his bag?? It's the only thing I can think of but why only happening recently. He's stored it in the same way for the last 3 years, not doing anything different, unless it's a change in the pen design??

 

[Hopeful34]

Have you tried opening a new box of pens with a different batch number? Or contacting the manufacturers?

I'd also look at a reusable pen, that you just change the cartridges each time (unless there's a reason for using disposable pens). They're better for the environment and take up less space in the fridge.

 

[becca59]

Could be that the pen says ml on but is a mistake. All sounds very strange.
What I will say is an air shot should be done each new needle to ensure the needles are working. I have on occasion had ones that are not. It isn’t wasteful it’s essential.

 

[Emma t]

It's been happening over the last several boxes. I live in Cyprus and its what is available on our NHS so I can't change the type. We don't seem to have a problem with the lantus pens but he only uses that once at bedtime so not transpiring it.

 

[Emma t]

Could be that the pen says ml on but is a mistake. All sounds very strange.
What I will say is an air shot should be done each new needle to ensure the needles are working. I have on occasion had ones that are not. It isn’t wasteful it’s essential.

Ok I didn't know that we were just told to do it when starting a new pen. Thanks

 

[Jaylee]

He uses disposable preloaded pens the dial won't click round when it empty. This is a new pen

Hi, I'm pretty sure he isn't doing extra to cover extra food he's a sensible kid and he was at home over Easter so kept a close eye and still going through the insulin too fast. Also his numbers are normal. The only thing I've noticed is if you dial up the units and then press the end without a needle on, it depresses and goes back to zero and when you put the needle in insulin comes out (a drop) without pressing anything. I'm wondering if some how it's getting turned and pressed in his bag?? It's the only thing I can think of but why only happening recently. He's stored it in the same way for the last 3 years, not doing anything different, unless it's a change in the pen design??

Hi @Emma t ,

Welcome to the forum.

Airshots should be performed to prime the needle prior to every injection.

One thing I’m wondering regarding the “phantom insulin use.”
Are there any exessive air bubbles in the cartridge? Which might explain a leak…

In all my decades of pen use. I’ve never known a pen pocket dial up & push a dose.