Humalog half units.

[gillrogers]

Think ive just found a problem with a half unit injection. It seems to express the half unit the minute you dial it up. When you inject theres nothing there. Just tried it outon two pens on a surface and its very hit and miss . Has anyone else noticed this. It does it with any number dialled. So it means you can be loosing half a unit most time from what im seeing.

 

[Inka]

What pen are you using @gillrogers ? Are you doing an air shot first? My Humalog pen doesn’t do this. Are you sure it’s not just a residual drop of insulin?

 

[rebrascora]

Could be the heat from your hands causing expansion and resulting in a little insulin coming out before you actually inject? I certainly see this and sometimes use it instead of an air shot to ensure that the needle is delivering insulin before I dial up the dose. Expansion of the insulin due to warmth can certainly cause a bead to form, before you actually dispense the dose. It will depend where you hold the pen ie. with fingers around the cartridge or via the plastic casing, as to whether this happens or not, so that might be why it is hit and miss. It should not affect the delivery of the insulin you have dialed up though.

 

[gillrogers]

What pen are you using @gillrogers ? Are you doing an air shot first? My Humalog pen doesn’t do this. Are you sure it’s not just a residual drop of insulin?

It’s the humalog junior quick pen. I double checked using a new pen as this one was nearly finished. Yes I had done the air shot first and cleared away the drops left from that first.

 

[gillrogers]

Could be the heat from your hands causing expansion and resulting in a little insulin coming out before you actually inject? I certainly see this and sometimes use it instead of an air shot to ensure that the needle is delivering insulin before I dial up the dose. Expansion of the insulin due to warmth can certainly cause a bead to form, before you actually dispense the dose. It will depend where you hold the pen ie. with fingers around the cartridge or via the plastic casing, as to whether this happens or not, so that might be why it is hit and miss. It should not affect the delivery of the insulin you have dialed up though.

I doubt it’s that to be honest Barbera. My hands are always cold and the new pen had just come from the fridge and I had cleared away residue from the air shot.

 

[Inka]

It’s the humalog junior quick pen. I double checked using a new pen as this one was nearly finished. Yes I had done the air shot first and cleared away the drops left from that first.

I don’t clear away residue from the air shot. I just let it drip off. Are you putting a new needle on each time? Unless the pen is faulty (faulty or overwound spring mechanism), I wouldn’t worry. Half a unit is a tiny amount to inject. Sometimes I wonder if it’s actually worked/gone in but you should be guided by your blood sugar. I’ve always found mine works.

Half a unit is 200th of a ml, so there would be a thousand of them on a teaspoon - ie a minuscule amount. I don’t always see it (sometimes I dial up half a unit to test my pen if it’s low on insulin) especially if it kind of shoots out in an aerated way.

 

[rebrascora]

I doubt it’s that to be honest Barbera. My hands are always cold and the new pen had just come from the fridge and I had cleared away residue from the air shot.

If it came from the fridge then it will almost certainly be expansion due to room temperature. I try to let it come to room temperature before I need it but if I put a needle on a new pen or cartridge you will always get insulin dispensed before you dial up a dose, because of that expansion. Usually you don't see it because the needle cover is on, but if you tap the needle cover on a surface you will likely see insulin come out in that situation, or if you take the needle cover off before you screw the needle on, you will see it will come shooting out. The fridge is about 4 degrees and the room is about 20 so there will be some expansion and that is normal.

 

[gillrogers]

If it came from the fridge then it will almost certainly be expansion due to room temperature. I try to let it come to room temperature before I need it but if I put a needle on a new pen or cartridge you will always get insulin dispensed before you dial up a dose, because of that expansion. Usually you don't see it because the needle cover is on, but if you tap the needle cover on a surface you will likely see insulin come out in that situation, or if you take the needle cover off before you screw the needle on, you will see it will come shooting out. The fridge is about 4 degrees and the room is about 20 so there will be some expansion and that is normal.

I hear what your sayong Barbera but this was done with a room temperature pen and a new one. When i air shot and cleaned it up from that, then dialed half a unit and cleaned the blob upthat oozed out and then pressed the button an a surface to see the drop expelled and waited but nothing came out. That shouldnt happen and it did with both pens a number of times.

 

[gillrogers]

I don’t clear away residue from the air shot. I just let it drip off. Are you putting a new needle on each time? Unless the pen is faulty (faulty or overwound spring mechanism), I wouldn’t worry. Half a unit is a tiny amount to inject. Sometimes I wonder if it’s actually worked/gone in but you should be guided by your blood sugar. I’ve always found mine works.

Half a unit is 200th of a ml, so there would be a thousand of them on a teaspoon - ie a minuscule amount. I don’t always see it (sometimes I dial up half a unit to test my pen if it’s low on insulin) especially if it kind of shoots out in an aerated way.

Well ive seen more blobs after ive injected than usual just lately and put it down to me. But my dbn yrsyerday told me to up a correctipn ratio as i seem to keep stopping short by what looks like half a unit. Then when i dialed up my lunchtime bolus i decided to experiment. And sure enough a number of times with new and old pen nothing came out after depressing the button. It is a tiny amount but i can see it.

 

[Inka]

Have you got a new box to try a pen from @gillrogers ?

 

[gillrogers]

Have you got a new box to try a pen from @gillrogers ?

Ooh thats a good idea. Yes i have.

 

[gillrogers]

Have you got a new box to try a pen from @gillrogers ?

Hope you can make sense of my little experiment photo. I think that says there is an intermittent doseage problem with the old box. The left side is the half unit dose given. The right side is the blob thats oozed out after it has been dialed up. I expect that to some degree as theres bound to he somethng left in the needle after tge airshot but you can clearly see the dosage given for a half unit is much smaller in the old box.

 

[trophywench]

You need such teeny doses of insulin - why on earth have you not been issued a pump?

 

[gillrogers]

You need such teeny doses of insulin - why on earth have you not been issued a pump?

I got told the other day that i wouldnt be able to cope when things go wrong with it. Ive got to get to grips with mdi first. At the moment i think i agree.

 

[gillrogers]

So having been using the new pens from the new box im now finding things are working much better. In fact that much better im having to shave a few minutes of my bolusing time and my highs arnt the 16s up as far as 20mmol spikes! So definately sure now that most meals where short of a half until!