Worth starting a new pen for the sake of 1 unit?

[BenjaminRWT]

So I've not long done my daily dose of insulin, I currently take 8 units of Lantus at 8 o'clock every evening.

I realised, after doing my 2-unit air shot, I was only able to dial up 7 units as that was all that was left in the pen. So I did my injection with that.

I will be keeping an eye on my levels throughout the evening and into tomorrow (I was recently provided with a libre 2 after an appointment, sensors on prescription), when I will take a new pen out of the fridge and take my current usual dose at my usual time.

But I have been wondering, when this surely happens again, is it worth it, having to use a whole new needle for the sake of 1 unit, especially when I'm using up 2 for the air shot?

 

[rebrascora]

You don't necessarily need to do a 2 unit air shot, just enough to see that the insulin is coming out of the needle. I usually just dial up half a unit and if i don't see a bead of insulin on the tip of the needle, I dial up another half unit until I do.... I appreciate you may only have whole unit disposable pens at the moment, so maybe try just one unit in the future. As long as you see a droplet of insulin coming out of the tip of the needle, that is all you need to see to know that it is primed and delivering insulin.

Yes, hardly worth bothering with another injection for just 1 unit and with you being newly diagnosed, it probably isn't going to make a big difference as you are likely still producing some insulin of your own.
Good that you have Libre to keep an eye on things. Do you also have bolus/meal time insulin and have you been instructed how to do correction doses yet? If so then you can always correct with bolus insulin if you are a bit high tomorrow morning.

 

[BenjaminRWT]

You don't necessarily need to do a 2 unit air shot, just enough to see that the insulin is coming out of the needle. I usually just dial up half a unit and if i don't see a bead of insulin on the tip of the needle, I dial up another half unit until I do.... I appreciate you may only have whole unit disposable pens at the moment, so maybe try just one unit in the future. As long as you see a droplet of insulin coming out of the tip of the needle, that is all you need to see to know that it is primed and delivering insulin.

Yes, hardly worth bothering with another injection for just 1 unit and with you being newly diagnosed, it probably isn't going to make a big difference as you are likely still producing some insulin of your own.
Good that you have Libre to keep an eye on things. Do you also have bolus/meal time insulin and have you been instructed how to do correction doses yet? If so then you can always correct with bolus insulin if you are a bit high tomorrow morning.

I was prescribed bolus insulin, novorapid to be specific. But I was told not to start taking it until told to. So it's remained in my fridge since getting it last month. I think they wanted to see how my levels were and determine doses from there.

So no, I haven't been instructed on correction doses at the moment.

 

[pawprint91]

Sorry to go slightly off topic, but I’ll never understand the “don’t take it until told to” approach (this was also the one used with me). I had to ring the hospital and pretty much beg to be allowed to use my novorapid, and if I hadn’t started carb counting off my own back for every meal (admittedly following a DAFNE style hospital course for this) then I don’t actually know when they’d have moved me from fixed doses for one meal to carb counting and figuring out my own ratios for every meal. I do understand they don’t want to overwhelm you when you’re so new to it all with carb counting etc, but surely a fixed dose after a big meal and some info about correction ratios etc can’t hurt to start people off with?

I think my point is - don’t be afraid to ask about using your novorapid if you feel it’s going to benefit you. Sorry we know this wasn’t your original question, but having been in your shoes it’s something I feel very strongly about. (And something that could benefit your situation were you using it and needed to correct etc)!

 

[everydayupsanddowns]

Ack! That’s annoying eh?! @BenjaminRWT 🙄

I’m not sure there’s a right or a wrong answer to that one.

From my experience I have seen that 1u of basal added or subtracted to my regular dose can make a major difference to my levels over the following day (though I’ve been T1 rather longer and probably have little if any home-grown insulin production left!)

Just keep an eye on your levels, and see what happens 🙂

 

[Lucyr]

So I've not long done my daily dose of insulin, I currently take 8 units of Lantus at 8 o'clock every evening.

I realised, after doing my 2-unit air shot, I was only able to dial up 7 units as that was all that was left in the pen. So I did my injection with that.

Why did you only take 7u if your dose is 8u, that’s a dose reduction of 12.5% which is quite a lot. I’d have done the remaining 1u with a new pen.

 

[everydayupsanddowns]

Why did you only take 7u if your dose is 8u, that’s a dose reduction of 12.5% which is quite a lot. I’d have done the remaining 1u with a new pen.

I think it was the faff and airshot required for just the extra unit.

Though expressing it as a percentage as you have makes 1u seem a bit more significant really!

 

[BenjaminRWT]

I think it was the faff and airshot required for just the extra unit.

Though expressing it as a percentage as you have makes 1u seem a bit more significant really!

Yeah.

Again, doing an airshot which uses up twice as much as I would be taking didn't seem right to me, as well as using a new needle to do it.

And yeah, as a percentage it seems bigger.

As for the whole having bolus insulin prescribed yet told not to use it... I'm baffled about that myself. Why prescribe it to me then tell me not to use it yet?

I will be attending a diabetic clinic in a couple of weeks... I will bring this up, if not before then.

 

[Lucyr]

Yeah.

Again, doing an airshot which uses up twice as much as I would be taking didn't seem right to me, as well as using a new needle to do it.

And yeah, as a percentage it seems bigger.

As for the whole having bolus insulin prescribed yet told not to use it... I'm baffled about that myself. Why prescribe it to me then tell me not to use it yet?

I will be attending a diabetic clinic in a couple of weeks... I will bring this up, if not before then.

There’s really no need to do a 2u airshot so if you didn’t want to do 2 jabs and saw your pen was getting to the bottom you could have just injected 8u and done either a 1u or 0u airshot. I rarely do one, pressing the end to see a bit of insulin appear is enough to know the pen is working.

 

[everydayupsanddowns]

Again, doing an airshot which uses up twice as much as I would be taking didn't seem right to me, as well as using a new needle to do it.

Ah yes… I was always a bit old skool with my MDI habits. A needle always did more than one jab for me. Oops!

 

[everydayupsanddowns]

I rarely do one,

Fair enough... but I got caught out not doing air shots in warm weather where things in the pen had flexed and I’d do a dose which had an unknown bzzzzt of no pressure before I felt the tension of the insulin.

I’d always recommend at least 1u myself. 🙂

 

[BenjaminRWT]

As this is still all very new to me, I've stuck to doing it how I was instructed, which is a 2u airshot, then the actual dose for injection.

I'm sure I'll get more confident as time goes on (let's face it, I'm doing this for the rest of my days!), maybe I could do only one unit, but I'm sticking to what I've been told for now.

 

[rebrascora]

I can see the benefit of having it on hand in case your levels suddenly rise dramatically and you need to ring 111 for advice and the doc who rings you back can then recommend you inject a certain amount, whereas it would need to be an emergency prescription if you didn't have it or possibly a trip to hospital via A&E, but to me if you are keen to start using it yourself and ready to learn carb counting, then your clinic should support you with that. It doesn't really make much sense just using basal to start with because you end up adjusting the dose to cover some of the glucose rise from your meals so in reality you likely end up with a higher basal dose than you actually need, so it is not like they are trying to get the basal dose right before they introduce bolus. Thankfully I was started on both at the same time although it was fixed doses for a few weeks before I saw the dietician and started carb counting... although I had learned carb counting from this forum before that as I was hell bent on reversing my Type 2 diagnosis with a low carb diet.

 

[Lucyr]

Fair enough... but I got caught out not doing air shots in warm weather where things in the pen had flexed and I’d do a dose which had an unknown bzzzzt of no pressure before I felt the tension of the insulin.

I’d always recommend at least 1u myself. 🙂

If I didn’t see insulin at the end of the needle, or I was reusing a needle I’d do 1u but pressing the plunger without dialling one up shows the needle is working because there’s no way for insulin to appear at the end of a new needle otherwise. I’d never do 2u airshot.

 

[BenjaminRWT]

Follow-up on this. Went right back to my usual 8u when I started the new pen.

My levels were a little higher for a day or two after I did the 7 unit dose. I don't know how much of that was down to a lack of activity as well - my job this week has entailed me be being stuck in a small back office for most of the day. Certainly doesn't help my levels post-lunch anyway. Big jump in the afternoon that takes a while to come back down.