Prescribing of insulin pens

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charlesehhopkins

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Does anyone know exactly how insulin pen devices are prescribed/chosen
in the UK, US, Spain or Germany? I am particularly interested in the UK
system but insight to any of the above would be useful.
As I understand it, patients are diagnosed with diabetes by an GP then
endocrinologist, who prescibes insulin treatment where necessary. The
patient then visits a diabetes educator/nurse who offers a broad range
of devices which the patient can choose from (often based upon
recommendation). Is this correct?
Specifically, how do patients choose which device is best for them? Do they get to
choose? Is it mainly on clinician/diabetes educator recommendation?
Any help
would be much appreciated.
Regards
Charlie
 
as far as i know, the device you use is closely linked to the type of medication you are on - eg i have two different insulin pens for my two types of insulin, as the cartidges of insulin are shaped differently therefore i have the pens that fit the cartridges.

it's been a long time since my diagnosis, so i'm not sure the exact procedure of what happens when you are diagnosed.
 
Hello Charlie and welcome to our forum. I'm type 2 so I am not entirely sure of the procedure.

I think (but only think and don't know for certain) who ever provides your care has at least some of the choice. It also seems to vary from area to area.
 
there are many different insulin devices.
Untill recently, my uncle was on pigs insulin, which could ony be prescribed in small glass vials. administered to person via sringe.

As far as i know most diabetics are placed on Nova human mixtard 30 upon diagnosis. this also comes in glass vials, but is mainly used in prefilled Pens, for ease of todays throw-away society.
It also comes in an 'innolet' which i belive was desgined for blind people. it is vaugely egg shapped, and click quite loudly when units are dialed up.

There are also multiple use pens, which you have to load the insulin cartridges into. and change when empty. the pen, or casing is kept. Mine is a half unit one due to insulin sensitivity.

I believe that there maybe children friendley ones, in various shapes and colours ect. but i have never seen one.

As shiv said, it will depend on the person specific needs.

(If anyone idsagrees with me, do correct me 🙂 )
 
Being a suspicious internet user, I am reluctant to fill in a survey from an anonomous person, especially as you have basically asked the same question twice in the same forum, you haven't filled in any pertinent questions in your profile and don't appear to know much about the UK NHS system. Does anyone get to see an endocrinologist, I would suspect only a few complex cases. GPs do most of the prescribing of drugs and insulin delivery devices. The majority of patients are not offered a choice.
 
Thanks for the feedback. The double question posting was an unfortunate error due to me not being used to the layout of the site. Apologies for that, I have now rectified this.
I do in fact have considerable knowledge of the intricate and often convoluted NHS system and corresponding NICE reimbursement schemes, however, feedback from a patient level rather than professional perception of how the system works is the aim of both my survey and the question I previously posed. You are correct in saying many people do not see a specialist endocrinologist, however my question was more related to how individuals choose/receive their device following this. Are you saying that in your experience a diabetes nurse/educator was not consulted and a GP simply recommended your device to you following diagnosis?
Kind regards
Charles
 
Unless you get referred to a hospital, certainly in this part of the UK your GP says I'm putting you on Levemir (or whatever). What choice is there, either disposable flexpen or cartidge pen. My GP specialises in diabetes. I really do not understand your question, patients do not get a catalog and asked to select the treatment and whilst we do refer to the likes of this forum it is very hard to argue with a trained specialist.
 
You may notice that I live in Scotland, I believe NICE does not apply.
 
I was diagnosed 2 years ago by my GP at the time. I was sent to hospital straight away because I was in severe DKA and my DSN at the hospital I went to decided on what insulin regime I would go onto. I didn't have the choice because I didn't know anything at the time about insulin.I think it varies from area to area what regime your put on and what your DSN/ consultant think's is the best regime for you to go on. GP didn't have anything to do with the process other than prescribing it for me. Hope this helps.
 
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