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Basal insulin compromised ?

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Pat91

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Hi, opened a new basal pen last night Abasaglar, had my usual units but woke up with a 16.9. took 6 units of quick acting. 2 hours later was at around 8. Went for a big walk and checked when I come back and had climbed to 13.9. have changed my pen anyway as there seemed to be a bubble moving quite freely in the pen. Do you think the basal is to blame ?
 
Its too difficult to tell from 1 off result, you could be brewing something or anything

Bubbles aren't a problem and you can generally get rid of them by pointing the pen towards the ceiling, tapping it gently so the bubble flows to the needle end and then doing an air shot whilst still pointing it upwards
xx
 
It could be the basal insulin itself or a faulty pen mechanism, but equally it could be slight illness, hormones, or a number of other possibilities. Changing the pen was sensible 🙂 See how that goes.

Longterm, see if you can get a proper reusable pen for the Abasaglar. I’m not sure if they do one? It’s easier and better to use 3ml pen cartridges and a re-useable pen. The re-useable pens are much sturdier and IMO more accurate because they’re built to last. It also makes travelling and collecting prescriptions easier as you have less bulk.
 
Google tells me that it would be a HumaPen for Abasaglar cartridges xx
 
Just did a quick Google @Type1Pat It seems you can get Abasaglar cartridges and they go in a re-useable Lilly pen. They come in packs of 5 cartridges.

If you can think back to your basal injection last night - was there anything ‘different’ that might explain the rise eg a different injection place?
 
Inka said:
Just did a quick Google @Type1Pat It seems you can get Abasaglar cartridges and they go in a re-useable Lilly pen. They come in packs of 5 cartridges.

If you can think back to your basal injection last night - was there anything ‘different’ that might explain the rise eg a different injection place?
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No all was the same as previous nights, only difference being the new pen itself.
 
That pen does seem a possible culprit then. Keep a close eye on this new pen to make sure it’s working ok.
 
Did you do the air shot before you injected and see insulin come out of the needle. There is always the possibility of the needle being blocked and the insulin not being administered if you didn't actually see insulin come out of the needle before you dialed up your dose.
 
I have got the same issue ... changed lantus Sunday after injecting sugars are going up and needing a lot more nova rapid than normal. Did check something was coming out before injecting
 
Freddie1966 said:
I have got the same issue ... changed lantus Sunday after injecting sugars are going up and needing a lot more nova rapid than normal. Did check something was coming out before injecting
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Just checked again and it didn’t work this time so frustrating
 
@Freddie1966 Are you naughty like me and reuse your needles or is this a new needle? I find with basal insulin that the needle clogs and blocks sometimes if you reuse needles and you have to be very observant with it. I also find that a bubble is more likely to develop in my Levemir cartridge than my quick acting insulin, and the bubble is nigh on impossible to air shot out for some reason, or maybe I am just reluctant to waste numerous units of insulin in an attempt to get rid of it. It doesn't always happen, but every 2nd or 3rd cartridge will develop an air bubble. For me the air shot is more to ensure that the needle is working and insulin is coming than to actually expel that bubble as it floats to the other end of the cartridge when I invert it to inject so unlikely to impact my dose.
 
rebrascora said:
@Freddie1966 Are you naughty like me and reuse your needles or is this a new needle? I find with basal insulin that the needle clogs and blocks sometimes if you reuse needles and you have to be very observant with it. I also find that a bubble is more likely to develop in my Levemir cartridge than my quick acting insulin, and the bubble is nigh on impossible to air shot out for some reason, or maybe I am just reluctant to waste numerous units of insulin in an attempt to get rid of it. It doesn't always happen, but every 2nd or 3rd cartridge will develop an air bubble. For me the air shot is more to ensure that the needle is working and insulin is coming than to actually expel that bubble as it floats to the other end of the cartridge when I invert it to inject so unlikely to impact my dose.
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I always use a new needle . I have a half dose pen just tested it , once it worked three times it failed . Always do an air shot but don’t look at how much has come out will from now on
 
I would be looking at your box of needles if that is the case. Find it hard to believe the pen is intermittently defective but obviously don't rule it out.
 
I’d also put a new cartridge in and take time making sure everything in the pen is just right - ie the plunger/screw bit, the way the cartridge is screwed in, that dirt, foil or something hasn’t for in to the mechanism, etc etc.

Then put your new needle on and do a few air shots. If it carries on being dodgy, just get a new pen. They do ‘wear out’ over time and become slack.
 
I usually just do a half unit air shot as long as I see a drip of insulin form on the end of the needle and run down. If I don't see a drop of insulin I dial up another half unit and try again. If it gets to 2 units and I still don't see insulin coming out I should probably ditch the needle but I dip the tip in boiling water for a few moments and try again and usually I get a result after that. I probably have an undiagnosed phobia about throwing anything out which is useable or fixable, so I can't just bin it unless it really doesn't work. I know it is pennies but it is just the way I am.
 
I was always told to do a 2 unit air shot. When I put a new cartridge in, I sometimes do two or three lots of 2 units to make sure it’s flowing properly. It’s not wasteful. Despite looking like an enormous stream of insulin, the amount is a tiny, tiny fraction of a teaspoon.
 
Yes, I am well aware that it should be a 2 unit air shot but if I am only using 1 or 2 units that seems like a huge waste to me... more than 50% waste on those occasions.... I know it is stupid and my health is worth more than that but it's the way I am and I am comfortable and confident that my system works with less waste, then I don't see it as a problem. I used to just change my needles once a week so I am slowly compromising (now twice a week and when a cartridge comes to an end) The important thing is to check each time that the needle is actually delivering insulin from the pen and that is my point.
 
It wasn’t a criticism @rebrascora You do what you feel best 🙂 I do the 2 units automatically, even for a half unit correction when I’m using my pen. I suppose I kind of visualise it flowing through the whole cartridge neck/needle thing like cleaning out a pipe or something ready for the injection:D

I do however make my lancets last a very long time - but that’s more laziness than an attempt to economise :D
 
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