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Do Insulin Pens Need To Be Primed

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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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 >>

Common Insulin Pen Errors: Diabetes Questions & Answers

Common Insulin Pen Errors: Diabetes Questions & Answers

Q. I recently switched from using syringes to inject insulin to using an insulin pen, and it seems like I need to inject more insulin with the pen to counter the same blood glucose level. The length of the needle seems to be the same, the pen is primed, and yet the pen injection has less of a blood-glucose-lowering effect. What could be going on here? A. The insulin contained in vials and pens is identical. So if you’re using your pen correctly, there should be no change in the effectiveness of the insulin on your blood glucose levels. It’s not unusual for people to be educated on how to use an insulin pen and to believe they are injecting with proper technique but to make one or more minor mistakes that affect the amount of insulin being injected. I recommend that you make an appointment with your diabetes educator or health-care provider and have that person observe you injecting a dose of insulin to see what, if anything, might be going wrong. Here are a few examples of common errors that can occur when administering insulin with a pen: A person may dial in the correct dose, put the needle into the skin correctly, but instead of pushing the button at the end of the pen to inject the insulin, dial the dose back to zero. This would result in no insulin being injected. Once the dose is dialed, the button has to be pushed in all the way — you should hear a series of clicks as you push — and then the pen must be held against the skin, needle inserted, for 6–10 seconds. Some people know that they need to push the button to deliver the insulin, but they don’t push it hard enough to inject the entire dose. Another common mistake is to fail to leave the needle in place for at least 6 seconds after pushing the button on the pen. If the needle is removed too soon, t 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 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 >>

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 >>

Package Leaflet: Information For The User

Package Leaflet: Information For The User

Lilly User Manual Instructions for Use Read and follow all of these instructions carefully. If you do not follow these instructions completely, you may get too much or too little insulin. Every time you inject: Use a new needle Prime to make sure the pen is ready to dose Make sure you got a full dose Also, read the Patient Information Leaflet printed on the back of this manual. Pen Features A multiple dose, disposable prefilled pen containing 300 units of U-100 insulin Delivers up to 60 units per dose in single unit increments Easy to use; compact size Pen Parts Important Notes Read and follow all of these instructions carefully. If you do not follow these instructions completely, you may get too much or too little insulin. Use a new needle for each injection. Be sure a needle is completely attached to the pen before priming, setting (dialling) the dose and injecting your insulin. Prime every time. The pen must be primed before each injection to make sure the pen is ready to dose. Performing the priming step is important to confirm that insulin comes out when you push the injection button, and to remove air that may collect in the insulin cartridge during normal use. See Section "III. Priming the Pen". If you do not prime, you may get too much or too little insulin. Make sure you get a full dose. To make sure you get a full dose, you must push the injection button all the way down until you see a diamond (¨) or an arrow (®) in the centre of the dose window. See Section "VI. Following an Injection". The numbers on the clear insulin cartridge holder give an estimate of the amount of insulin remaining in the cartridge. Do not use these numbers for measuring an insulin dose. Do not share your pen. Keep your pen out of the reach and sight of children. Pens not being used s Continue reading >>

Levemir® Flextouch® Is Ready To Use In Just A Few Steps

Levemir® Flextouch® Is Ready To Use In Just A Few Steps

Levemir® FlexTouch®, a prefilled insulin pen with no push-button extension, requires low force to inject at all doses and is ready to use in just a few steps.a In fact, Levemir® FlexTouch® has up to 77% less injection force than Lantus® SoloSTAR®. From the makers of the world’s #1-selling prefilled insulin pen,b Levemir® FlexTouch® is: Accurate—Accurate dosing from 1 to 80 units Prefilled—Each pen is prefilled with 300 units of Levemir® Discreet—Fits in your pocket, purse, or nightstand On the go—Take it with you almost anywherec aPlease see the Patient Information for complete Instructions For Use. cOnce in use, Levemir® FlexTouch® must be kept at room temperature below 86°F for up to 42 days. Injecting with Levemir® FlexTouch® You may have concerns about using an injectable medicine for type 2 diabetes. But it’s important to realize the positive effect it may have on the management of your diabetes. And once you gain a little practice in giving injections on your own, Levemir® injections will become part of your daily routine. If you were given instructions from your health care provider on how to use Levemir® FlexTouch® and you have read the Instructions for Use in the Patient Information, you may be ready for your first injection. Your health care provider will tell you what dose of Levemir® is right for you and how many times to take it each day. Your dose may be adjusted based on your blood sugar. Please consult your health care provider prior to adjusting your dose. No compatible source was found for this video. Levemir® can be injected in the thigh, abdomen, or upper arm. It’s important to change the injection site within your injection area each time you inject and not inject into the exact same spot each time. Rotating where yo 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 >>

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 >>

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 >>

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 >>

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 >>

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 >>

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 >>

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