ARGH! Kwikpen/cartridges.......?!

[lauraw1983]

Every single prescription I have had (diabetes related) since diagnosis in November except one, there has been a problem with that I am having to run about and solving!

My clinic normally send requests to the GP, the problem is the GP not reading anything properly it seems, either that or the requests being emails are not being relayed to the GP correctly!!! I am fed up of it 😡

Over Xmas I was given 2 Kwikpens - one humalog and one humilin I. The Humalog is nearly finished, hence asking for the script to be sent.

My MIL picked them up yesterday for me, and I got home to discover cartridges! Hence various phone calls, the pharmacist was most helpful and said the cartridges were more "old style" and that most people got Kwikpens now...? anyway she had none of the pens that the cartridges go in, in stock anyway so couldn't have supplied one last night.

Spoke to DSN finally and she said I can go to the clinic today and she can give me a pen for them to go in, it's inconvenient as I am at work today but I know needs must etc....🙄

Do most of you use pens and cartridges or Kwikpen type things!? And will my 5mm needles for the Kwikpen fit the other cartridge type pen the same....I am hoping the answer to that is yes!!

 

[Northerner]

What a pain! As far as I know, needles are universal and fit all pens (the exception, I think, being the newer click-on needles, or whatever they are called). I have always used pens and cartridges - in fact I'm still using the same novopen 3 that I was issued with at the hospital! I have a spare in case it breaks. I had real problems with my surgery trying to get a single-unit lantus pen - they issued me with three incorrect pens before I got the one I wanted - and I'd even put the PIP code on the request which they had clearly ignored! Grrr!!!

I hope this is the last problem you have for a very long time! 🙂

 

[MeanMom]

Hi

Clinic told me they reserved Kwikpens for 'younger kiddies' and we were issued with cartridges. Don't mind as felt the Kwikpen very flimsy, and if I remember correctly did half units so dial was too small for K to read (we don't need half units, sometimes I think we could just measure in 10's😱)

You really don't need to have all this Agro on top of learning to cope with D - I hope your clinic and Docs can get their act together pretty quick for you.🙂

 

[imtrying]

What a palava!! Sometimes I think the world doesn't think we have it inconvenient enough with just dealing with diabetes so sends us all these extra lovely inconveniences!

I used to use disposable pens when on mixed insulin (and I was a kiddie), but ever since being on MDI I've been on pens and cartridges. Takes up much less space in the fridge! 🙂

Hope you get all sorted.

 

[novorapidboi26]

I use disposables for both my Levemir and Novorapid, the Nordisk Flexpen variety..........

Before MDI, it was a pen and cartridge of Humulin M3..........and I thought I would never like the disposables as well...................love them now........

The mix up your experiencing is incompetence from someone along the line......who though is anyone's guess.......

I send an email to my surgery then pick up the meds 2 days later..........smooth sailing......🙂

 

[Monica]

What a palaver!!!
This happend to my friend last week. She was changing from MDI to twice daily (don't ask!!!!). When she picked up the insulin it came as cartridges instead of flexpens. She doesn't understand why, because she's always used flexpens. She noticed it while still at the pharmacy (in the GP's building), so she complained there and then. The receptionist said she couldn't get anyone to prescribe her a pen.... The pharmacist wouldn't give her a pen without a prescription!!!! Irate, she said : I am Diabetic you know, I need the insulin. What use is it if I don't have the instrument to inject it with?????? The reply: From our records we KNOW you have enough insulin keep you going!

Shame she didn't tell me sooner, I could have given her one of Carol's old pens.

 

[Northerner]

...she said : I am Diabetic you know, I need the insulin. What use is it if I don't have the instrument to inject it with?????? The reply: From our records we KNOW you have enough insulin keep you going!
....

Ooh, they're very lucky it wasn't me they said that to! 😱 😡

 

[everydayupsanddowns]

...the pharmacist was most helpful and said the cartridges were more "old style" and that most people got Kwikpens now...

I'm not sure I agree with that. Cynically I suspect that reps are keen for the prescribers to go 'disposable' because there is more money in it for them.

I've only ever used reusable pens and have never had any bother getting carts, new pens etc.

Disposable pens always seem v flimsy and plasticky affairs.

Each to their own though 🙂

 

[novorapidboi26]

What a palaver!!!
This happend to my friend last week. She was changing from MDI to twice daily (don't ask!!!!). When she picked up the insulin it came as cartridges instead of flexpens. She doesn't understand why, because she's always used flexpens. She noticed it while still at the pharmacy (in the GP's building), so she complained there and then. The receptionist said she couldn't get anyone to prescribe her a pen.... The pharmacist wouldn't give her a pen without a prescription!!!! Irate, she said : I am Diabetic you know, I need the insulin. What use is it if I don't have the instrument to inject it with?????? The reply: From our records we KNOW you have enough insulin keep you going!

Shame she didn't tell me sooner, I could have given her one of Carol's old pens.

I think some of the isophane insulin, or the twice a day ones dont come in disposables, purely down to supply and demand.................the less demand, the more chances of cartridges to fit into a pen [humapen etc..]

 

[lauraw1983]

I'm not sure I agree with that. Cynically I suspect that reps are keen for the prescribers to go 'disposable' because there is more money in it for them.

I've only ever used reusable pens and have never had any bother getting carts, new pens etc.

Disposable pens always seem v flimsy and plasticky affairs.

Each to their own though

Hmm I an cynical too and wondered this...! I wonder what the price difference in the BNF is for cartridges v Kwikpens.....? I really must register on that site actually.


Anyway I went at lunchtime and saw my DSN, had a quick catchup with how I was getting on, explained some of my readings (always going high between lunch and dinner, and still a bit high in the mornings most days) and she has now given me a cartridge of Lantus to try from tonight, just 6u to begin with to be cautious, and take from there....should give better 24 hour coverage for basal needs.

I do believe I said all this the other day 🙄

So will see how the Lantus goes and take it from there over the next couple of weeks, I may need a different script than Humulin I anyway! I just got 15 cartridges yesterday 🙄😱

I have 2 much nicer (reusable) pens now, and hard cases that they go in - much better for my handbag etc!

 

[lauraw1983]

Irate, she said : I am Diabetic you know, I need the insulin. What use is it if I don't have the instrument to inject it with?????? The reply: From our records we KNOW you have enough insulin keep you going!

Shame she didn't tell me sooner, I could have given her one of Carol's old pens.

Grrrr FGS, how unhelpful is that? I cannot stand rude and bad service, absolutely no need.

That's how I felt last night re; the cartridges with no pens - where is the common sense here?!?!

when I am settled on the correct insulins etc, I am going to make a GP appt and list everything I need sorted out and try to "align" my prescriptions so I can ask for everything (I need more BG strips at a time too) I need at once every month or whatever & just get it delivered! All this running about it just annoying!

 

[Northerner]

Anyway I went at lunchtime and saw my DSN, had a quick catchup with how I was getting on, explained some of my readings (always going high between lunch and dinner, and still a bit high in the mornings most days) and she has now given me a cartridge of Lantus to try from tonight, just 6u to begin with to be cautious, and take from there....should give better 24 hour coverage for basal needs.
...

Hmm...I would set your alarm for 3am if you are just starting out on lantus, and on 6 units. It may not sound a lot, but I am currently on two units of lantus and woke this morning to a 4.4, so I would do that 3am test to make sure it's not sending you too low in the night 🙂

 

[lauraw1983]

Hmm...I would set your alarm for 3am if you are just starting out on lantus, and on 6 units. It may not sound a lot, but I am currently on two units of lantus and woke this morning to a 4.4, so I would do that 3am test to make sure it's not sending you too low in the night 🙂

I was on 8u of Humulin I, which is why she said to reduce it to 6u for Lantus as a "just incase". No mention of a 3am alarm.....do you still think it sounds too much...?!

I am not in work tomorrow anyway so could do that tonight with less ill effects than if I have to be up v early for work!

 

[novorapidboi26]

you should always consider a 3 am test when changing basal dose and/or basal insulin.................'just in case' you go low overnight..........🙂

 

[Northerner]

I was on 8u of Humulin I, which is why she said to reduce it to 6u for Lantus as a "just incase". No mention of a 3am alarm.....do you still think it sounds too much...?!

I am not in work tomorrow anyway so could do that tonight with less ill effects than if I have to be up v early for work!

Ah, sorry, I got mixed up with what you were on and didn't realise it was a replacement 🙂 I'd still be tempted to do those tests just to see what's happening - 3am is normally the time at which your liver is at its least productive, glucose-wise, so it would give you an idea about how things were going for you overnight (i.e. from your bedtime, to 3am, to waking 🙂 But then I am a little obsessive at times! 😉

 

[lauraw1983]

Ah, sorry, I got mixed up with what you were on and didn't realise it was a replacement. I'd still be tempted to do those tests just to see what's happening - 3am is normally the time at which your liver is at its least productive, glucose-wise, so it would give you an idea about how things were going for you overnight (i.e. from your bedtime, to 3am, to waking. But then I am a little obsessive at times! 😉

S'ok, so am I. Diabetes is one of the worst things I could have gotten, as a control freak. And I hate maths. 🙄

I will do that then. Why did my DSN not even mention it? Infact they never have, even when I started on Humulin I..........I only know about it from here! 😱

 

[Northerner]

S'ok, so am I. Diabetes is one of the worst things I could have gotten, as a control freak. And I hate maths. 🙄

I will do that then. Why did my DSN not even mention it? Infact they never have, even when I started on Humulin I..........I only know about it from here! 😱

They may be under the mistaken belief that a night hypo will always wake you up, but as I live alone I'd rather not take the chance - if I didn't wake up no-one is likely to notice for some time. Sounds dramatic, I know, but better safe than sorry in my book. As it happens, I did get woken by hypos a few times in the early days, but I wasn't told about night testing back then either. As I was on 20 units back then and am currently on 2, you can imagine the propensity to drop low overnight was quite high! I think they should explain properly to people so at least they are aware of the risks. If the DSNs etc. don't understand the importance of such knowledge then there is a gap in their training in my opinion.

 

[Copepod]

To answer a few qustions / points:

According to BNF, for most insulins, the cost is the same for a box of cartridges or a box of disposable pens. But that doesn't take account of cost of disposal of used pen or cartridge, as pen is so much bulkier, so you get far fewer in a sharps / medical waste bin.

As a back up in case of pen failure, everyone should always have access to a disposable syringe (1ml with 1 unit divisions, 100 per 1ml), which can be prescribed or bought from chemists (or probably blagged for free, if you can persuade the chemist you inject street drugs!) It's possible, if a bit fiddly, to draw up insulin in syringe, after inserting needle into rubber end of cartridge whether or not it's in the pen.

 

[everydayupsanddowns]

As a back up in case of pen failure, everyone should always have access to a disposable syringe (1ml with 1 unit divisions, 100 per 1ml), which can be prescribed or bought from chemists..

Easy enough to get insulin syringes on prescription. Many on pumps (inc me) use them as a back-up device.

 

[imtrying]

They may be under the mistaken belief that a night hypo will always wake you up, but as I live alone I'd rather not take the chance - if I didn't wake up no-one is likely to notice for some time. Sounds dramatic, I know, but better safe than sorry in my book. As it happens, I did get woken by hypos a few times in the early days, but I wasn't told about night testing back then either. As I was on 20 units back then and am currently on 2, you can imagine the propensity to drop low overnight was quite high! I think they should explain properly to people so at least they are aware of the risks. If the DSNs etc. don't understand the importance of such knowledge then there is a gap in their training in my opinion.

We'd all notice it on here Alan!! We'd have the ambulance round in no time if we'd not seen a post from you on here by 8.30am!! 🙂