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Do Insulin Pens Need To Be Primed

Practical Aspects Of Insulin Pen Devices

Practical Aspects Of Insulin Pen Devices

Go to: Introduction Numerous studies have shown that insulin pen devices have several advantages over the traditional vial-and-syringe method of insulin delivery, including improved patient satisfaction and adherence, greater ease of use, and superior dosing accuracy.1–7 Despite these advantages, the use of insulin pen devices in the United States remains low compared with other developed countries.8 About two-thirds of insulin prescriptions in Europe and about three-quarters in Japan are for pen devices.9 In contrast, in the United States, only 15% of patients are thought to use insulin pens.10 Possible reasons for the low adoption rates in the United States include lack of awareness among health care providers of the advantages of pens compared with the vial and syringe.8,11 An additional issue is the greater prescription cost of insulin cartridges and prefilled insulin pens compared with insulin vials, although the cost to the patient may be the same depending on their coverage; in fact, if they have one copay per box of pens, the cost to the patient may actually be less per unit of insulin. It should be noted, however, that despite the higher unit cost of insulin in pen devices versus vials, several studies have found that overall diabetes-related treatment costs are lower with pen devices than with vial and syringe.1,2,12 In addition, most pen devices have good formulary coverage. For example, the FlexPen® prefilled pen is covered on more than 90% of managed care plans.13 Therefore, in theory, costs should not prevent the use of these devices.14 However, many smaller health maintenance organizations and state Medicaid plans may require prior authorization for insulin pens. Given the clinical, practical, and potential health economic advantages of insulin pens, t Continue reading >>

Insulin Pen Benefits – Advantages And Disadvantages Of Insulin Pens

Insulin Pen Benefits – Advantages And Disadvantages Of Insulin Pens

People with diabetes who use insulin traditionally use a vial-and-syringe method for delivery. An insulin pen has become another alternative for delivering insulin. Find out more about the advantages and disadvantages of insulin pens. How Insulin Pens Work Insulin pens have an attached insulin cartridge rather than using a syringe and separate vial. Pens contain cartridges that last somewhere between 2-4 weeks and must be disposed of after expiration or when empty. Insulin pens require insulin pen needles that are replaceable and need to be changed and disposed of after each injection. Pen needles are usually thin and short, between 4-6 mm, for optimum comfort. There is no need to pinch up the skin with these shorter needles; just inject straight into the skin. If you are using longer pen needles between, 8-12.7 mm, then you need to pinch up the skin to prevent injecting the insulin directly into muscle. Most pre-filled pens must be discarded within 14-40 days depending on the insulin type. Patients should always verify the time frame with the package insert as brands will vary. If the insulin pen you are using contains 2 different types of insulin, you must roll the pen back and forth to mix the two insulins before each injection. Never use insulin that contains floating particles or clumps inside the cartridge. Remember, with any insulin, the injection site must be rotated each time. Ease of Use Patients report an easier overall injection experience when using an insulin pen. Pens tend to be more socially friendly because they are smaller and less noticeable than the classic vial-and-syringe. Insulin pens are more portable for people on-the-go. Pens that are open do not need to be refrigerated and can be thrown into a pocket or purse for easy travel. Room temperature Continue reading >>

How To Use An Insulin Pump

How To Use An Insulin Pump

Tweet When you get started on a pump, you should be given full training on how to use and get the most out of your new pump. This guide therefore serves as an introduction to what’s involved in using an insulin pump for those wanting an insight into day to day usage of an insulin pump. Setting up an insulin pump The steps below serve as a guide to what’s involved in setting up a typical tethered insulin pump. Fill the reservoir This typically involves either drawing insulin from a vial into the reservoir or loading a new cartridge of insulin into the reservoir. It’s best to try to reduce the amount of air going into the cartridge. Attach the infusion set Attach the infusion set (tubing connected to a cannula) to the reservoir outlet. Prime the pump Priming the insulin pump is activated by pressing controls on the insulin pump which tells the pump to start moving the plunger. Priming is used to push any air out of the tubing and the reservoir Insert the infusion set With as much air removed from the tubing and reservoir as possible, the next step is to apply the infusion set to your body. Areas such as the abdomen (tummy), thighs, buttocks and the arms (unless very lean) are good areas to use. Applying the infusion set involves pushing the cannula under the skin and holding it in place with an adhesive patch. Some infusion sets can be implanted with a tool to help insert the cannula smoothly and consistently. Setting the basal rate of insulin Insulin pumps don’t use long acting insulin, instead they constantly deliver a small amount of fast acting insulin through the day. The basal rate can be set and changed at any time at the press of a few buttons. Your health team will help you to set a basal rate, i.e. how much background insulin you receive each hour. When Continue reading >>

Does Anyone Have A Pen?

Does Anyone Have A Pen?

Insulin pens have been available for over a decade as an alternative to traditional insulin syringes and are an increasingly popular option for insulin delivery. Pens are more convenient than syringes and are quite accessible for diabetics with blindness, low vision or fluctuating vision. What is the difference? The basic insulin syringe comes unfilled and is intended for a single use, although many diabetics choose to reuse syringes. You must fill the syringe manually each time a dose is required. Unfortunately, if you are blind or suffer from low or fluctuating vision, you need a special device like the Count-A-Dose (available from the NFB’s Independence Market) to fill the syringe independently and accurately. Insulin pens are not disposable. Their base holds a 300-unit insulin cartridge which connects to a disposable screw-on needle. This cartridge stays attached until it is empty or until it has been out of refrigeration for over thirty days. The screw-on needles are intended for a single use. However, many diabetics choose to use the pen needle for a day or so. Dosing Dilemma Solved Dosing with an insulin pen is incredibly quick and simple, even if you have limited vision. The base piece has a dial or knob on the end opposite the insulin cartridge and needle. The insulin dose is both measured and administered from the pen using the dial. In all of the pens that we tested, turning the dial creates both an audible and tactile click. Some pens measure by half units while others measure by whole units. For example, if your pen doses in whole units and you wish to measure seven units, you simply twist the dial seven clicks. Because of innovative design, no air enters the cartridge, eliminating another concern for visually impaired diabetics. After measuring the insul Continue reading >>

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What is Toujeo®? Prescription Toujeo® is a long-acting insulin used to control blood sugar in adults with diabetes mellitus. • Toujeo® contains 3 times as much insulin in 1 mL as standard insulin (100 Units/mL) • Toujeo® is not for use to treat diabetic ketoacidosis • Toujeo® should not be used in children Important Safety Information for Toujeo® (insulin glargine injection) 300 Units/mL Do not take Toujeo® if you have low blood sugar or if you are allergic to insulin or any of the ingredients in Toujeo®. Do NOT reuse needles or share insulin pens even if the needle has been changed. Before starting Toujeo®, tell your doctor about all your medical conditions, including if you have liver or kidney problems, if you are pregnant or planning to become pregnant or if you are breastfeeding or planning to breastfeed. Heart failure can occur if you are taking insulin together with certain medicines called TZDs (thiazolidinediones), even if you have never had heart failure or other heart problems. If you have heart failure, it may get worse while you take TZDs with Toujeo®. Your treatment with TZDs and Toujeo® may need to be changed or stopped by your doctor if you have new or worsening heart failure. Tell your doctor if you have any new or worsening symptoms of heart failure, including: • Shortness of breath • Swelling of your ankles or feet • Sudden weight gain Tell your doctor about all medications you take, including OTC medicines, vitamins, and supplements, including herbal supplements. Toujeo® should be taken at the same time once a day. Test your blood sugar levels daily while using insulin, including Toujeo®. Do not make changes to your dose or type of insulin without talking to your doctor. Verif Continue reading >>

How To Properly Inject Insulin With An Insulin Pen

How To Properly Inject Insulin With An Insulin Pen

Insulin pens are an easy, accurate and convenient way to administer insulin to patients with diabetes. The insulin is injected using a small disposable pen needle that attaches to the insulin pen. Every commercially-available insulin pen follows the same set of steps for preparing and injecting insulin, with only minor differences. The major components of an insulin pen are a prefilled insulin reservoir, a knob for dose measurement, a dose window, and an injection button. There are 5 main steps to follow for injecting your insulin: preparing the pen, priming the pen, using the pen, disposal and storage. Preparing the pen: 1. Wash your hands prior to using the pen. 2. Pull off the cap and inspect the insulin reservoir. Most insulin should be clear, colorless, and free of particles. Exceptions to this rule are Humulin N/Novolin N and any premixed insulin, which will appear thick, cloudy, and white. These insulin’s must be mixed prior to use by rolling the pen between your hands and moving the pen up and down 10 times. 3. Wipe the rubber seal of the insulin reservoir with an alcohol swab 4. Attach a new, unused, pen needle for each injection by removing the protective tab and screwing the pen needle onto the pen tightly. 5. Pull off the outer cap of the pen needle but do not throw it away. It will be used later to discard the needle. 6. Pull off the inner cap of the pen needle and throw it away. Your insulin pen is now prepared and ready for priming. Priming the pen: Must be done before each injection 7. Prime the pen before each use by dialing to 2 units and pressing the button to shoot some insulin into the air to make sure it works. Repeat this process until you see a drop of insulin appear at the needle tip. 8. If no insulin appears at the needle tip, change the need Continue reading >>

Using Novolog® Flexpen®

Using Novolog® Flexpen®

Here is a quick guide to NovoLog® dosing using NovoLog® FlexPen®. Please read the full Instructions For Use that came with your FlexPen® carefully before using it. To see FlexPen® in action, watch the video below. FlexPen® Demo Video (7:05 min) This video shows you how to use your NovoLog® FlexPen®. NovoLog® FlexPen® should not be used by people who are blind or have severe visual problems without the help of a person who has good eyesight and who is trained to use NovoLog® FlexPen® the right way. Wash your hands. Check the label to make sure that you are using the right type of insulin. This is especially important if you take more than 1 type of insulin Pull off the pen cap. Wipe the rubber stopper with an alcohol swab Remove the protective tab from the needle and screw it onto your FlexPen® tightly. It is important that the needle is placed on straight Never place a disposable needle on your FlexPen® until you are ready to take your injection Pull off the big outer needle cap and then pull off the inner needle cap. Throw away the inner needle cap right away Always use a new needle for each injection Be careful not to bend or damage the needle before use To reduce the risk of needle stick, never put the inner needle cap back on the needle Small amounts of air may collect in the cartridge during normal use. To avoid injecting air and ensure proper dosing: Turn the dose selector to 2 units Hold your FlexPen® with the needle pointing up, and tap the cartridge gently a few times, which moves the air bubbles to the top Press the push-button all the way in until the dose selector is back to 0. A drop of insulin should appear at the tip of the needle If no drop appears, change the needle and repeat. If you still do not see a drop of insulin after 6 tries, do n Continue reading >>

Please Click Here For Full Important Safety Information And Here For Full Prescribing Information For Lantusâ®.

Please Click Here For Full Important Safety Information And Here For Full Prescribing Information For Lantusâ®.

Ou te r n ee dle c ap Inn er n ee dle c ap Pr ot ec tiv e se al Ru bb er se al Ins uli n re se rvo ir Do se w ind ow Do se se lec to r Inj ec tio n bu tto n Pe n ca p Ne ed le HOW TO USE YOUR LANTUS® SOLOSTAR® PEN A STEP BY STEP GUIDE TO USING YOUR LANTUS® SOLOSTAR® PEN This quick reference guide is a short version of the instruction leaflet. It is designed to help make it easier to learn the steps. Reading this guide will help to make sure that you inject the right amount of insulin every time. Otherwise you may get too little or too much insulin, and that can affect your blood sugar levels. These instructions are supplied as a guide only. Read the full instruction leaflet accompanying this pen before you use Lantus® SoloSTAR® for the first time. To help ensure an accurate dose each time, follow all steps in the leaflet. If there’s anything you don’t understand or if you have any questions, ask your healthcare provider. You can also go online to Lantus.com or call the support line at 1-800-633-1610. GETTING TO KNOW YOUR PEN AND ITS PARTS The Lantus® SoloSTAR® pen was designed with a simple-to-push injection button and large dosing window. For single patient use only What is Lantus® (insulin glargine injection) 100 Units/mL? Prescription Lantus® is a long-acting insulin used to treat adults with type 2 diabetes and adults and pediatric patients (children 6 years and older) with type 1 diabetes for the control of high blood sugar. • Do not use Lantus® to treat diabetic ketoacidosis. Important Safety Information for Lantus® (insulin glargine injection) 100 Units/mL Do not take Lantus® during episodes of low blood sugar or if you are allergic to insulin or any of the inactive ingredients in Lantus®. Do not share Continue reading >>

So You’re Ready

So You’re Ready

Indication BASAGLAR is a long-acting insulin used to control high blood sugar in adults and children with type 1 diabetes and adults with type 2 diabetes. Limitation of Use Important Safety Information Do not take BASAGLAR during episodes of low blood sugar or if you are allergic to insulin glargine or any of the ingredients in BASAGLAR. Do NOT reuse needles or share insulin pens, even if the needle has been changed. Before starting BASAGLAR, tell your doctor about all your medical conditions, including if you have liver or kidney problems, if you are pregnant or planning to become pregnant, or if you are breastfeeding or planning to breastfeed. BASAGLAR should be taken once a day at the same time every day. Test your blood sugar levels while using insulin. Do not make any changes to your dose or type of insulin without talking to your healthcare provider. Any change of insulin should be made cautiously and only under medical supervision. The most common side effect of insulin, including BASAGLAR, is low blood sugar (hypoglycemia), which may be serious and life threatening. Signs and symptoms may include dizziness or light-headedness, sweating, confusion, headache, blurred vision, slurred speech, shakiness, fast heartbeat, anxiety, irritability, mood change, or hunger. Do NOT dilute or mix BASAGLAR with any other insulin or solution. It will not work as intended and you may lose blood sugar control, which could be serious. BASAGLAR must only be used if the solution is clear and colorless with no particles visible. Always make sure you have the correct insulin before each injection. BASAGLAR may cause serious side effects that can lead to death, such as severe allergic reactions. Get emergency help if you have: Heart failure can occur if you are taking insulin together w Continue reading >>

How Do I Use Them?

How Do I Use Them?

How Do I Use Them? “My Doctor Says I Should Begin Using an Insulin Pen...†BD Getting Started™ Using Insulin Pens and Pen Needles An insulin pen is a convenient way to give yourself an insulin shot or injection. It looks like a large fountain pen and comes in two basic types: disposable and reusable. Disposable pens come already filled with insulin. When a pen is empty or expired, it is simply discarded. Reuseable pens have a replaceable cartridge of insulin. The cartridge is replaced when the insulin is used or expired. Whichever type of pen you use, you will need to attach a new pen needle onto the pen with each injection and remove it after every use. The pen may be kept in your pocket or purse at room temperature while in use. The insulin should not get warm or be exposed to direct sunlight. Store unused insulin pen cartridges and pre-filled pens in the refrigerator. Note: Pens from different manufacturer’s operate differently. Check pen manufacturer’s guidelines for operating instructions and insulin expiration details. Dosers are larger and easier to handle than insulin pens. They have clear, readable dials and easy-to- grip shapes that are designed for people with vision problems and poor hand control. An insulin doser works like a re-useable pen. It holds a replaceable cartridge of insulin. The dose is dialed and delivered through a pen needle. Insulin Pens and Dosers – easy to carry, dose and use Parts of a Pen Needle Each pen needle has an outer shield, an inner shield, and a paper tab. How to attach the needle to a pen 1. Remove the paper tab from the outer shield. 2. Push the needle straight onto the pen and twist until it is tight. 3. Pull off the outer shield and set it aside. You will need it later to remove the needle Continue reading >>

Using Tresiba® Flextouch®

Using Tresiba® Flextouch®

Do not take Tresiba® if you: are having an episode of low blood sugar are allergic to Tresiba® or any of the ingredients in Tresiba® Before taking Tresiba®, tell your health care provider about all your medical conditions, including if you are: pregnant, planning to become pregnant, or are breastfeeding taking new prescription or over-the-counter medicines, vitamins, or herbal supplements Talk to your health care provider about low blood sugar and how to manage it. Do not take Tresiba® if you: are having an episode of low blood sugar are allergic to Tresiba® or any of the ingredients in Tresiba® Before taking Tresiba®, tell your health care provider about all your medical conditions, including if you are: pregnant, planning to become pregnant, or are breastfeeding taking new prescription or over-the-counter medicines, vitamins, or herbal supplements Talk to your health care provider about low blood sugar and how to manage it. Read the Instructions for Use and take Tresiba® exactly as your health care provider tells you to Do not do any conversion of your dose. The dose counter always shows the selected dose in units Know the type and strength of insulin you take. Do not change the type of insulin you take unless your health care provider tells you to Adults - If you miss or are delayed in taking your dose of Tresiba®: Take your dose as soon as you remember, then continue with your regular dosing schedule Make sure there are at least 8 hours between doses If children miss a dose of Tresiba®: Call the healthcare provider for information and instructions about checking blood sugar levels more often until the next scheduled dose of Tresiba® Check your blood sugar levels. Ask your health care provider what your blood sugar levels should be and when you should che Continue reading >>

Using Insulin Pens And Pen Needles

Using Insulin Pens And Pen Needles

How Do I Use Them? “My Doctor Says I Should Begin Using an Insulin Pen...†BD Getting Started™ An insulin pen is a convenient way to give yourself an insulin shot or injection. It looks like a large fountain pen and comes in two basic types: disposable and reusable. Disposable pens come already filled with insulin. When a pen is empty or expired, it is simply discarded. Reuseable pens have a replaceable cartridge of insulin. The cartridge is replaced when the insulin is used or expired. Whichever type of pen you use, you will need to attach a new pen needle onto the pen with each injection and remove it after every use. The pen may be kept in your pocket or purse at room temperature while in use. The insulin should not get warm or be exposed to direct sunlight. Store unused insulin pen cartridges and pre- filled pens in the refrigerator. Note: Pens from different manufacturers operate differently. Check pen manufacturer’s guidelines for operating instructions and insulin expiration details. Parts of a Pen Needle Each pen needle has an outer shield, an inner shield, and a colored peel tab. Insulin Pens – easy to carry, dose and use How to attach the needle to a pen 1. Remove the colored peel tab from the outer shield. 2. Push the needle straight onto the pen and twist until it is tight. 3. Pull off the outer shield and set it aside. You will need it later to remove the needle from the pen. 4. Pull off the inner shield and prime your pen before injecting. Always prime your insulin pen before each injection Always refer to the instructions of the pen manufacturer when preparing your pen for use. Dial two units on your pen and then press the button to shoot some insulin into the air to make sure it works. This is called an “air shot†Continue reading >>

Insulin Pens

Insulin Pens

WHAT YOU NEED TO KNOW: What is an insulin pen? An insulin pen is a device used to inject insulin. The pen contains a cartridge of insulin. The pen may be reusable or disposable. You may need a different pen for each type of insulin you use. How do I get the insulin ready to use? Check the label and color of the insulin. Check that you have the correct type and strength of insulin. Insulin pens are available as U100 and U500 strengths. Also check the expiration date on the label. Use a new cartridge or pen if the expiration date has passed. Short or rapid-acting insulin should be clear, colorless, and free of particles or clumps. Use a new cartridge or pen if the insulin does not look right. Follow the pen manufacturer's instructions for inserting a new cartridge into a reusable pen. Mix cloudy insulin. Gently roll the pen back and forth between the palms of your hands. Repeat this 10 times. Do not shake the pen. This can make the insulin clump together. Next, gently tip the pen up and down 10 times. Do not use the insulin if there are clumps in it after you mix it. How do I get the pen ready to use? Remove a new pen from the refrigerator 30 minutes before you use it. Insulin should be injected at room temperature. Wash your hands. Use soap and water or an alcohol-based hand rub. This will help decrease your risk for an infection. Remove the cap from the pen. Wipe the needle attachment area with an alcohol swab. Attach a needle to the pen. Remove the tab from the needle. Do not remove the outer cap on the needle. Push the needle straight onto the pen. Turn the needle clockwise until you cannot turn it more. Make sure the needle is straight. Remove the needle caps. Remove the outer cap and save. Remove the inner cap and throw it away. Remove air from the pen. Air may caus Continue reading >>

Giving Yourself An Insulin Injection With The Lantus Solostar Pen

Giving Yourself An Insulin Injection With The Lantus Solostar Pen

This information describes how to prepare and give yourself an insulin injection (shot) with the Lantus® SoloStar® pen. Your nurse will review these steps with you and help you practice them. Storing Your Lantus® SoloStar® Pen Keep all new, unused insulin pen devices in the refrigerator. Do not freeze them. Never put the pen you are using back in the refrigerator. Keep it at room temperature, away from heat and sunlight. Discard the Lantus® SoloStar® pen 28 days after piercing the rubber stopper. Gather Your Supplies Clear off a clean, flat tabletop to work on and gather the following supplies: Lantus® SoloStar® pen A new single-use pen needle Alcohol swabs A wastebasket A sharps container (a strong, plastic container with a tight cap). Do not store your sharps in glass bottles, soda bottles, milk jugs, aluminum cans, coffee cans, or paper or plastic bags. For more information, please read How to Store and Dispose of Your Home Medical Sharps. Wash your hands thoroughly with soap and water or use an alcohol-based hand sanitizer. Open an alcohol swab and wipe the rubber tip at the top of the pen (see Figure 1). Remove the tabbed paper from the outer case of a new single-use needle (see Figure 2). Follow the steps below to prime the pen, set your dose, and inject the insulin. You must prime the pen before you set your dose and inject the insulin. You will do this by giving an “air shot.” This removes the air bubbles and ensures the pen and needle are working properly. Dial 2 units (to the number 2) on the dose selector dial by turning it clockwise (see Figure 6). You will hear and feel a faint click for each unit as you turn the dial. The punger button on the pen will also rise. If you dial past 2 units, turn the dose selector counterclockwise to correct it. Po Continue reading >>

December 2013, Vol 1, No 2

December 2013, Vol 1, No 2

Two landmark studies, the Diabetes Control and Complications Trial and the United Kingdom Prospective Diabetes Study, have shown the importance of glycemic control in patients with type 1 or type 2 diabetes to help minimize macrovascular and microvascular complications.1 Insulin is the drug of choice in many patients with diabetes used to help achieve glycemic control. However, insulin use in the United States is often underutilized because of the stigma and other barriers associated with the use of vials and syringes. Throughout the years, insulin delivery systems have been ever-changing as new technology is developed. Insulin was first discovered in the 1920s and the delivery system utilized glass vials and reusable needles (sharpened with a pumice stone).1 Sterilization by boiling both the needles and syringes was required before use. Insulin vials and syringes were used for more than 60 years before the introduction of the insulin pen in 1985.1 The first insulin pen, NovoPen, was a metal reusable pen that was loaded with insulin cartridges.1 This allowed patients with diabetes to have the freedom to continue with their active lifestyles. Although there are a few reusable insulin pens still available, advancements in technology have since replaced the insulin reusable pen with disposable plastic prefilled pens (Table).2 Insulin pens are an option for many patients and can be simpler to administer compared with a vial and syringe. As insulin pen delivery devices are becoming more popular in the community, what do pharmacists need to know to tell their patients who are new to insulin pens? Supplies Needed for Insulin Injection If patients have previously been using the insulin vial and syringe method, then they are used to injecting themselves several times a day. But Continue reading >>

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