Suggestion to Avoid Insulin Overdose

[rebrascora]

I don't understand this bit so I am not sure my pens function the same. Do you mean the button comes out further the more you dial up? I had not ever noticed that even with my disposable pens, but then I was on small doses when I used disposables, but I don't think it is the case with the NovoPen Echo.

Cancel that..... I just tried it and it does push the button out further but not enough difference between 5 and 10 units to be aware of the difference without comparing them.

 

[rebrascora]

It is still too much palava every day to mitigate a very small risk of something that might happen once every couple of years or more, which I have taken steps to mitigate already but also feel I can manage the situation if I do get it wrong. I will almost certainly pick up the primed pen and dial up a half unit without thinking as I always do and then shoot 10.5 units into the air probably most mornings because it is harder to break a habit before forming a new one.

 

[Satan’s little helper]

It is the case, (I just checked) but it doesn’t come out very much further for larger dial-ups, so I doubt I'd notice. What I would notice, though, is if I dialled back so I could do an air shot, I 'd notice how many clicks I’d dialled back. (or not, pre Novopen Echoes, I was capable of injecting, looking at the pen and wondering if I'd just injected or not).

The LCD dose & timing memory function came in on the Novopen 5? I would admit the daily routine can leave me wondering, “did I just dose?” These things are such an integral part of our life’s.

 

[Robin]

The LCD dose & timing memory function came in on the Novopen 5? I would admit the daily routine can leave me wondering, “did I just dose?” These things are such an integral part of our life’s.

True! I did have an earlier model, with a basic clock face counting down the rough elapse of time. Not as sophisticated as the Echo, but it sure saved my moments of did I didn’t I?

 

[Proud to be erratic]

I'll make this my last post on this thread but will try just once more to explain the concept & the apparent misconception around pre-dialling.

The idea behind pre-dialling, as @rebrascora picked up on, is NOT that you're predicting your next dose. NOR is it preventing an air shot. It is simply a visual prompt when you pick up the pen, especially critical if you should accidentally pick up bolus instead of basal.

Illustration
Your typical basal is 20u & bolus is 5u. You pre-dial these values after each injection. Should you then pick up the bolus pen instead of the basal, you will see that it's set to 5u. This should act as a pretty big deterrent to then go ahead & administer 20u of bolus in error.

Now I accept that this isn't going to work if your pen can't go backwards, something that as I said I was unaware of. Not only do both of my pens go backwards but they also "unscrew" to set the dose. So even in the dark it should be pretty obvious whether the pen your holding has 5u or 20u dialled in. Again, other pens may vary.

Final point for those who missed the first word of the thread title, this is a SUGGESTION...

@RBZ5416 suggestions are always welcome and you shouldn't feel too aggrieved that others offer a different view. Just by airing this suggestion you are helping newer members to know that this mistake is a possibility and come to see that many seasoned users of MDI have done this. How others respond is all part of life's rich pattern (or life's frustrations), we're all different and the vast majority of people are creatures of habit and resistant to change. I certainly am - my Consultant has told me 3 times that Fiasp might be better for me and I'm still reluctant to change, preferring the devil I know over grappling with a new mindset.

Thank you for your suggestion. I look forward to most of us discussing this very topic again in 2 or 3 years time.

 

[everydayupsanddowns]

Yes, the air-shot remains essential. Slightly perversely the more MDI time you get under your belt the easier it is to become complacent and not screw the needle on correctly thus get no insulin or just a portion.

It’s so important not to forget air shots in my experience (I was a victim of that complacency several times)

During the summer where temperature varies, and seemingly especially where the pen had been carried vertically, I had the experience more than once where the plunger on my trusty Novopen didn’t stay connected to the little rubber bung on the cartridge, and there would be an unknown number of characteristic ‘slack’ clicks when I dialled up a dose before the insulin actually started delivering.

So for folks who would find this visual dose reminder helpful, remember to wind the dose back down do do your air shot once you’ve got the right pen in your hands 🙂

 

[nonethewiser]

Always did air shot first & still do, taught to do this from day 1 but it was more important back then as you were drawing up insulin into a syringe so air bubbles were inevitable.

 

[Hepato-pancreato]

Lifes to short and sometimes complicated to faff about using this "sugestion". If you unfortunately inject too much insulin by accident and realise as i have done straight away. Correct it with your choice of glucose goodies. If not detected your libre will pick it up. If your unlucky not to have one deal with the unfortunate hypo as usual. It's not like it's going to happen daily. Sorry to stick my oar in couldn't resist.

 

[Wonky]

That only works if you have a big disparity in basal/bolus doses, though. I take 5-6 units of Levemir in the morning and 3 at night, which is very similar to the sort of bolus dose I need for meals and snacks. I always inject my basal when I’m in bed, either side of sleeping, so I keep my basal pen by my bed.

Snap, easier to keep the basal pen in my bedside table rather than with any of the other D paraphernalia!