Nordisk Echo plus pen

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gillrogers

gillrogers

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Type 1.5 LADA
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Hi has anyone who uses the Echo Plus pen experienced a problem where you dial up the number of units you need, then you inject but the lcd screen says you’ve injected something completely different? I dialled up 7 units but it says I only gave 0.5 units. I’m going to trust what I dialled up. Just wondered if it’s a known problem
 
Blimey, that's poor. Some folk, me included could easily think they dialed wrongly, and fire in an adjustment.
 
No not heard of that at all and it is quite worrying.
Is it possible the mechanism stuck/jammed when you were injecting and it only dispensed half a unit? Did it feel like it worked properly when you pressed the button to release the mechanism and deliver the insulin.

Have you tried dialing up a couple of units since and doing an air shot to see if it is working OK now?
 
@gillrogers are you looking at the lcd display as soon as you have given yourself the insulin or a few hours later?
I am not familiar with these pens as they were not available when I migrated to a pump but I am wondering if the display is showing an approximation of the insulin on board. It is usually assumed fast acting insulin lasts 4 hours and is "used up" linearly - so a quarter of the dose is used every hour. If you dose 4 units, after 1 hour you have 3 units IOB, after 2 hours, you have 2 units IOB, etc.
 
helli said:
Fair enough. I will go back in my box and only write about what I have experience of. 🙄
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Absolutely no harm in throwing ideas out there even if they are off the mark or you don't have a good understanding or experience of the subject. Isn't that how brainstorming works?
 
helli said:
Fair enough. I will go back in my box and only write about what I have experience of. 🙄
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Practically they can't (they don't know what kind of insulin they're injecting and I suspect there's no energy to do it since the battery is just a fixed thing (it lasts 4-5 years and is then dead)). I suspect the pen wouldn't be the right place to do it anyway because the screen's really tiny and the interface is so limited.

Overall they're not that smart, but I could imagine phone apps offering that kind of information (based on dose information they read from the pens), and for all I know those apps already do that. But the basic information the pen gives is of value since it answers the "have I injected already" kind of question.
 
Bruce Stephens said:
I could imagine phone apps offering that kind of information (based on dose information they read from the pens), and for all I know those apps already do that.
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Yeah, my pump app does this.
I tell the app how many carbs I plan to eat, it calculates the dose, communicates with the pump and then keeps track of insulin on board. It also talks to my CGM so I don't have to open another app and scan to see my current BG. (I self fund the CGM.)

This is a typical view of my app screen with a lot of useful information in a very small space.
 

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I've had a modest handful of pen (needle) failures over the last 30 months. The first couple (disposable pens) put me in panic mode. I kept the first 5, with needles still attached and out of curiosity I bothered to unscrew the needle to look further - before disposing of them. In each case it transpired I'd bent the internal filament within the needle housing, preventing any flow. Clearly, in hindsight, my error. I always go through the motions of an air shot, but (formerly - no longer so) not so diligent in checking flow has actually occurred. So disposable pen failure explained.

I recently had a failure with my NovoEcho pen, but didn't panic, noted how much had potentially been dispensed and then checked the needle fitting. Sure enough the inner filament was bent over. So I assumed that, even though the display told me 2 units had been dispensed, this was actually unlikely and repeated the full bolus with a new needle (carefully fitted and flow checked!). All went well, no overdosing seemed to have occurred - but I was mindfull of that possibility and scanned fairly frequently for the next 4 hours. In practice, because I routinely have my Libre low alarm set at 5.6, I would expect to get plenty of advance warning if I had over-bolused and thus plenty of opportunity to compensate.

I am in no doubt that, despite my less than happy experiences with Libre, the alarms and trend info are a huge step forward from finger pricking. Events such as pen failures (or needle misfitting) become very easily managed and not a cause for extra stress.
 
helli said:
Yeah, my pump app does this.
I tell the app how many carbs I plan to eat, it calculates the dose, communicates with the pump and then keeps track of insulin on board. It also talks to my CGM so I don't have to open another app and scan to see my current BG. (I self fund the CGM.)

This is a typical view of my app screen with a lot of useful information in a very small space.
Click to expand...
I could imagine LibreLink (either the one for Libre 1 and 2 or the one for Libre 3) offering something similar (when used with these smart pens, or when you enter the insulin doses). I don't expect they'll do it, since I suspect that would need regulatory approval of the changes (which might well not be that used anyway).

Just reading the information from the pens (and uploading to LibreView) seems simpler and obviously useful so I'm pretty sure that's all they'll do.
 
I used to use an echo for Levemir, but switched to my backup after dose problems. I would dial up the insulin, push the release and only get part of the dose and then push the release again to try to get the rest.

Immediately after that I checked the echo to see if it was working properly I would dial up half a unit as an air shot. Hours later when I check the echo it shows half a unit.

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I would suggest that either you dialed half a unit of insulin (if your glucose level mysterious goes up that would be best guess), or you dialled up a half unit after your regular shot, by accident, and then forgot about it.
 
sorry everyone for not getting back sooner to all your replies. So my levels have gone as planned on a 7 which is what I was pretty sure that I had dialled. Don’t think I would have done that extra half . It’s fairly stiff to turn so pretty sure I couldn’t have do it accidentally. I did do an air shot of 7 after I noticed the half unit reading and it did register a 7. I’ll just keep an eye on it.

Thanks again everyone
 
And on the back of the, I’ve just done my evening basal shot and the air shot of 2 units showed an error on the display. I’m confident it’s dispensing the right amount as that’s the usual twist to dial and push the end in to dispense . I’m sure now this is probably a chip fault in the end.
 
gillrogers said:
I’m sure now this is probably a chip fault in the end.
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If it's giving an error then there's presumably a fault, so you should ask for another one. I guess if it's a few years old then maybe just ask for another one on prescription (maybe the battery is running low), but if it's very new I guess the manufacturer ought to replace it.
 
Thanks Bruce, I went to their website and I can come up with error if it can’t get the reading up quickly enough . But it will still dispense the right amount. It was fine this morning so I’ll keep my eye on it just in case I had done something myself before I send it back.
 
I’d certainly call them @gillrogers - they may be able to troubleshoot what has been happening - and if there have been other users who have notified them about similar issues they might have a record of affected lot numbers?
 
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