Pen Trouble, Help!

[Fallenstar]

I was on Apidra and had the old Optiset pen's that were first used by Noah on the Ark I think, they were to be phased out by Christmas any way, even before the Apidra debacle set in. This pen moved up in 2 unit increments so it was hard for me to do a correction dose of even dose adjustment for that matter as I have a low unit to carb ratio.

I was then given for a week the Solar star pen (Apidra) which moved up in 1 unit increments, I struggled to get 1 unit out of it :shock: I had to do a few biggish test shots and then would plump for two units to be honest as 1 unit on it was a barley visible drop right on the end of the needle.
Which I know is not what 1 unit looks like....are you following this ramble :lol:

Anyway I now have Novorapid with the Novopen junior which goes up in 1/2 increments. I have just gone to do a correction dose and needed 1 unit as I'm about to exercise....Nothing,zilch,nada! Again, even after a couple of biggish test shots...How the heck do people go on and parents with babies who may need 1/2 ,1 unit doses??? Because I am insulin sensitive and exercise so much I was given the 1/2 unit pen but I even struggled to get a 1 and a 1/2 unit dose out of it, another drop :shock:

Can anyone help or advise, as I really do need the one, and half unit increments to properly adjust and the old Apidra pens seemed to me to be better at smaller doses even though they were two unit increments
Thanks

 

[rockin_plumber]

We thought the same when our son was changed from a Novopen 4 to a Novopen junior...
It just didn't seem to be delivering enough on the test shot compared to the Novopen 4.

We did the 20 unit test and it was delivering the correct amount so we tried them.

To be fair we seem to be managing his BS levels fine with them so I would try it and just be concerned if things don't do what you think they should.

On a side note I did read somewhere that you can't give a 1/2 unit injection with these pens even though they start at 1/2. So the minimum you can give is 1 unit.

 

[Fallenstar]

Thanks for your help Rocking Plumber

When you say you did the 20 unit test what do you mean?

I had another little go with it at tea, I needed a decent dose for that meal 6 units and it seemed fine...but I did try again to get 1 unit,nothing even after a good high test. Then 1 1/2, a tiny drop came out, I and 1/2 units would drop me 5 mmol, a lot more if I was running so I do need these doses :cry: Even 2 units looked a bit on the lame side with this pen....You are right I will have to see how I go, but my team went the extra mile to get me the half increment pen and it now seems bizzare that the 1/2 increment does not seem to work but I suppose it will on the bigger doses...time will tell.

Glad things are working out for your Lad

 

[rockin_plumber]

Its a function check that makes sure it is delivering correctly...
It should be in the manual for the pen..

Look here...

http://www.farmamed.biz/PDF%5CNovoPen_Jr_Manual.pdf

Page 27 of the manual or page 18 of the pdf file...

Hope this helps

 

[AMBrennan]

Based on my Humapen priming instructions (to use 2u as anything less won't be enough to get the required stream) I think that you may be expecting a bit too much - each 300u cartridge contains 3ml, which is about 1.5 M&Ms...

 

[smidge]

Hi Fallenstar!

As you know, I use Apidra. I used to use the clikstar pen (which I like a lot), but it doesn't do half units, so I now use the Lily Humalog Deluxe (or something like that) pen with the Apidra. It works very well (as long as you pierce the cartrige before you insert it) - although my DSN was nervous letting me try it as you're not supposed to use it with anything other than Humalog. Anyway, I digress! I prime the pen by dialling two units, tapping it and shooting the insulin in the air - if this works, I assume the pen and needle are both working. Then dial up what I need and inject. Usually, I need 2.5 to 3.5 units - I have a similar ratio to you. It works well. I have never tried squirting half or one unit into the air, so I don't know what that dose would look like. Just inject your calculated dose and see if it does what it should - mine does. Why do you think it is not giving you the correct dose? The Novo Junior pen is supposed to be one of the most accurate on the market. Have you found it is not doing what you expect to your BG? Could this be the change from Apidra to Novorapid rather than the pen? Just a thought.

Smidge

 

[moonstone]

It doesn't matter what it looks like, half a unit of novorapid works exactly like half a unit of novorapid. I use the same thing. Half a unit here or there counts if you're sensitive to it. There are countless reasons why your one-time correction trial of half a unit didn't work. Eg your sugars were actually climbing, not steady and level, when you injected it, or you were ill, or your period was due, or you'd just had quite a milky cup of coffee. The list goes on. You haven't got pen trouble, as long as you do the 20 unit test as previously described every time you change a cartridge then you know your pen is fine.

 

[Fallenstar]

Right I did the 20 unit test on the Novo pen junior, it was cooking with gas but still when I did a 1 unit test shot after nothing 1 and 1/2 unit, nothing....two unit test shot, a tiny amount...All these small test shots I did after quiet a large test shot to get the stream of insulin flowing.
Now, having injected for 20 years and mostly being on small increment doses I have got used to what a 2 unit dose looks like, and always did a test shot and a dose shot.
A bit of a waste I know but when you are insulin sensitive and using small doses of bolus, needs must I'm afraid...and with the Novo junior it was wrong, compared to other bolus insulins I have used over the years..even when I compared it to the to the Levemir pen which spat out 1 unit lovely this morning Not that I would ever need this facility on the Basal insulin but I just thought I'd compare it.
So I surmise that it is a faulty pen...simple as.
I was also given a Novo Nordisk 1 unit increment pen, so this morning after doing a failed correction dose last night with the junior pen :x I tried this and it works fine...Even without a test shot, it is kicking out 1 unit just fine (and it looks like 1 unit) .
It is a shame, as because I am insulin sensitive and do a lot of Marathons I thought the 1/2 unit would be good for me but to be honest I would rather have a pen that did what it was supposed to.
I never did imagine for one second that I would be able to give myself just 1/2 a unit at any one time, a very big ask ...but for it not to work at 1 unit was a bit of a shock and as I said earlier it must be faulty. I will have to take it back to my Team.
Thanks peeps

 

[iHs]

Hi Fallenstar!

As you know, I use Apidra. I used to use the clikstar pen (which I like a lot), but it doesn't do half units, so I now use the Lily Humalog Deluxe (or something like that) pen with the Apidra. It works very well (as long as you pierce the cartrige before you insert it) - although my DSN was nervous letting me try it as you're not supposed to use it with anything other than Humalog. Anyway, I digress! I prime the pen by dialling two units, tapping it and shooting the insulin in the air - if this works, I assume the pen and needle are both working. Then dial up what I need and inject. Usually, I need 2.5 to 3.5 units - I have a similar ratio to you. It works well. I have never tried squirting half or one unit into the air, so I don't know what that dose would look like. Just inject your calculated dose and see if it does what it should - mine does. Why do you think it is not giving you the correct dose? The Novo Junior pen is supposed to be one of the most accurate on the market. Have you found it is not doing what you expect to your BG? Could this be the change from Apidra to Novorapid rather than the pen? Just a thought.

Smidge

Well done Smidge for chaning over to using a Lilly pen to put Aventis cartridges in. I have the Luxura HD 0.5u pen and have used it since 07 and it's still as good as new.

On reading this thread I tested a bolus dose of just 0.5u and it delivered it ok as this was something that I had never done before.

I really don't know why Aventis haven't produced a pen that delivers in 0.5u increments :?: I'm sure that lots of people have changed insulins because of it.

 

[Fallenstar]

I'm liking the sound of this Lilly Humalog Deluxe :wink: Infact, the name alone dose it for me :wink: :lol:
I am preempting that I may need a slightly larger dose of the Novo rapid as apposed to the Apidra, so I may be OK on the 1 unit increment pen but if I find I may still get better control with the 1/2 unit I will be down for asking for one of the Lilly pens. They sound very accurate.

Thanks for the info Peeps

 

[iHs]

Novo also do a Novo Demi pen that delivers in 0.5u increments. It's a dreadful colour though - orange yuk lol

 

[AMBrennan]

More correctly, it's "Humapen Luxura HD" - the HD is important because the're a regular Humapen Luxura as well.

 

[moonstone]

Right, I've tested for you. 1/2 unit comes out at one solitary drop. If your pen's giving out absolutely nothing, and you've already done the 2 unit air-shot to make sure there's no air bubbles trapped in the chamber, then yes, the pen's faulty. I mention the air-shot because my boss has had it a lot longer than you and he never does the air-shot, not everyone does for some reason. If you load up 1/2 unit after that and still nothing comes out, just get another one, mine's completely fine.

 

[smidge]

Hiya!

Well done Smidge for chaning over to using a Lilly pen to put Aventis cartridges in. I have the Luxura HD 0.5u pen and have used it since 07 and it's still as good as new.

Yes, it has worked really well for me. I was back at the hospital on friday and although my DSN said she couldn't believe I'd persuaded her to let me try the Lilly pen with Apidra cartridges, she gave me a second one as a spare - with the 'on your head be it' warning! It does work without problems.

Smidge