People with diabetes, especially type 1, are required to adequately control their blood sugar levels, so they must manage their insulin needs by injection up to several times a day. However, the constant need to maintain this injection regimen can be both stressful and disruptive.
As a result, insulin pens are growing in popularity as an alternative to the traditional syringe and vial for injections since they are more convenient and easier to use. Insulin pens may be disposable or reusable, and include an insulin dose cartridge, a dosage indicator and a disposable needle. Once it is time for an insulin injection, the needle is attached to the tip, and insulin is injected subcutaneously into fatty tissue.
It is important to use an insulin pen correctly to ensure that all required insulin has been injected for optimal use and consistent blood sugar levels. Choosing the right injection site and properly handling the pen will ensure its safe and effective use.
Choosing the Right Insulin Pen
There are two main types of insulin pens available: disposable and reusable. Within each type, they vary in price, the type of insulin held, and dosing levels.
Disposable pens contain a prefilled insulin cartridge that is disposed of once the cartridge is empty, or the pen has been in use for 28 or 32 days (depending on the insulin type).
Reusable pens contain replaceable insulin cartridges that can be placed into the pen and then removed when all the insulin has been injected, leaving the pen ready for the next cartridge. The disposable needle must be replaced after each insulin injection. If cared for properly, these insulin pens can last for several years.
While reusable pens are initially more expensive than disposable pens, the replacement cartridges for these pens are less expensive than the replacement disposable pens, so both pens are actually similarly priced over the long term.
Another consideration when choosing a pen is how the insulin dosages are handled. Some pens can provide doses in half-unit increments (for example, 1.5 units), while others dose in whole units. Lower-dosing pens are often better for children who have type 1 diabetes and require smaller doses of insulin.
Additional factors to consider when choosing an insulin pen include the number of units of insulin the pen can hold when full, how large a total dose can be injected; how the amount of insulin remaining is indicated on the pen, and whether your insurance covers a specific insulin pen that is on their list of preferred prescription drugs.
Choosing the Right Pen Needles
The pen needles are easily screwed onto the top of the pen, but you must change the needle after each injection in order to lower the chance of infection. Most pen needles sold will fit any of the insulin pens. These needles come in various lengths, usually between 4 and 12 mm, and various thicknesses (gauges).
A shorter needle is very effective for all body types. The goal is to deliver the insulin just below the skin without hitting the muscle beneath, as this affects the rate of insulin absorption.
A higher gauge needle is a thinner needle and causes less pain. However, if a large dose of insulin is needed at one time, a thicker needle may make for faster insulin delivery and help to avoid medication leaking out of the skin.
Storing your pens
An important first step is to check the expiration dates of the insulin pen cartridges, keeping in mind that expiration dates vary with the type of insulin used. New insulin pens should always be stored in the refrigerator, but once a pen has been used, it must be kept at room temperature (15 C – 30C) and out of direct sunlight.
According to the American Diabetes Association, when a person stores insulin at room temperature, it is good for 28 days to 32 days depending on the type of insulin.
Insulin pens should never be stored with the needle attached, even if the attached needle is new. This can affect the sterility and cleanliness of the needle, interfere with the insulin dose given, and increase the risk of infection.
The Benefits of Using Insulin Pens
Insulin injections are more convenient with pens because they combine the medication and syringe in one handy unit. Unlike traditional syringes, these pens come preloaded with insulin, including premixed types. They are also easy to use: just twist or snap on a new needle, dial the dose needed, inject the insulin, and dispose of the used needle into a needle-safe, sharps container.
Since certain insulin pens are disposable, so you can get rid of the pen once the insulin is used up or expired, while reusable pens continue their use once a new insulin cartridge is inserted.
One result of this ease of operation is greater confidence in the accuracy of the insulin doses administered by these pens. The desired doses can be pre-set on the pen’s dosage dial.
This is especially useful for diabetics who have impaired vision or manual dexterity issues.
A study conducted by the American Diabetes Association showed that 73% of people using insulin pens were confident about their greater dose accuracy, while only 19 percent were as confident that they were getting the right dose using vials and syringes.
Since these pens are portable and travel-friendly, they are also great time savers, and really helpful for young diabetics who need to inject insulin at school. The small and thin needle sizes on insulin pens also reduce fear and pain, an important consideration when working with younger diabetic children.
It is especially helpful that many brands of insulin pens are now color-coded and use different designs to help identify which type of insulin they contain, ensuring that the right insulin will be administered. A new development is the “smart pen” that comes with a digital application, where you can download and track when you last injected insulin and the amount used.
Insulin pens can also serve as a backup or substitute for insulin pump therapy in the event of a problem with the latter.
While insulin pens provide many benefits, they may not be for everybody:
It is a good idea to check your insurance to determine if your coverage allows for the increased cost of insulin pens, and if so, by how much. Compare the expenses for other diabetes management tools to see which one makes the most sense for your circumstances.
If you are active and eat several times a day, you may want to consider the number of times a day you will have to use these pens versus that of a pump, which does not require shots. Multiple daily injections can be cumbersome.
When you require more than one type of insulin for your regularly timed injections, it is important to note that first, not all types of insulin are available for use in pen cartridges, and second, you cannot mix two different types of insulin in one pen. This means that in some cases, two separate injections will need to be administered.
How to use these pens
Follow manufacturers’ instructions closely for using an insulin pen, as they vary slightly by manufacturer.
People who have never before used an insulin pen should seek advice from their healthcare provider before beginning to do so.
Preparing your Insulin Pen for Use:
Insulin should be injected at room temperature, so when using a new pen, remove it from the refrigerator 30 minutes before use. Be sure to wash your hands before proceeding to decrease the risk of infection
Check the expiration date and make sure that the insulin is the correct type and strength. If it has expired, throw out the disposable pen; follow the manufacturer’s instructions for inserting a new cartridge into a reusable pen;
Mix the insulin if it is cloudy. The best way is to roll the pen back and forth between the palms of your hands ten times. Do not shake the pen, as this can make the insulin clump together. Next, gently tip the pen up and down10 times. Do not use the insulin if clumps are present after mixing. If it is necessary, insert a new cartridge into a reusable pen.
Remove the pen cap, and wipe the needle attachment area with an alcohol swab.
Firmly attach a new needle to the top of the pen, but do not remove the outer cap on the needle; then push the needle down onto the pen and turn the needle clockwise until it cannot turn anymore. Make sure the needle is straight.
Remove air from the pen, because any trapped air may cause pain during injection. This is accomplished by turning the dial to two units and pointing the needle up. Gently tap the pen to move any air bubbles to the top. Press the injection button; a drop of insulin should appear on the tip of the pen. If you do not see this, change the needle and repeat. When you still do not see a drop after this step has been repeated 3 times, use a new pen.
Turn the dial to the dose needed, but this cannot be greater than the number of units left in the pen. You will have to use another pen if there is not enough insulin left. An economical option is to inject part of your dose with the insulin that is left in the original pen, and then use a new pen to inject the rest of your dose.
Choosing Insulin Injection Sites
It is best to inject insulin into your abdomen, hip, buttocks, upper arm, or the front or side of your thigh. Insulin actually works fastest when it is injected into the abdomen, but do not inject within 2 inches of your navel or into any area with stretch marks.
Insulin should not be injected into areas near a wound or a bruise, since insulin injected into these areas may not be absorbed properly.
When insulin is injected into the same location multiple times, it can cause lumps, swelling, or thickened skin. Use a different area within the chosen site each time you inject insulin.
Injecting Insulin with your Pen
Wipe the injection site with alcohol, and allow the area to dry.
Grab a fold of skin, and gently pinch the skin and fat between your thumb and first finger.
Hold the pen at a 90-degree angle, make sure the needle penetrates the skin all the way, and then release the pinched tissue.
Push the injection button, and continue to inject the insulin, keeping the needle in place for 10 seconds.
Withdraw the needle, and replace the needle cap. Press on your injection site for 5 to 10 seconds, but do not rub. This will keep insulin from leaking out.
Remove the needle from the pen by twisting the capped needle counterclockwise. Place the needle in a sealed sharps container.
Replace the pen cap and store the pen as directed.
If you have diabetes, and you require insulin injections, you may be interested in using insulin pens. Insulin pens can increase dose accuracy; they are portable, and usually easier to use. Discuss this option with your healthcare provider to determine which insulin pen is right for you.
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