Insulin Delivery Options
There are many ways to take NovoLog®. You and your health care provider will choose the way that works best for you. Some people take their insulin injection using a vial and syringe or an insulin pump. But many people who take NovoLog® use an insulin pen called NovoLog® FlexPen®. NovoLog® FlexPen® There are many reasons why NovoLog® FlexPen® is widely used. NovoLog® FlexPen® does not stand out the way an old-fashioned vial and syringe might. So most people who see you take out your FlexPen® probably won’t even know what it is. This may make you feel better using it in front of others in restaurants, at work, and even at home. Your FlexPen® is prefilled with NovoLog® insulin. And, it’s ready to use in just a few steps. Simply dial the exact amount of insulin you need and inject by pressing a button. View NovoLog® FlexPen® instructions online or download a printable patient brochure. NovoLog® FlexPen® fits in a pocket or purse and is: Able to deliver from 1 to 60 units of insulin Adjustable in 1-unit dosing amounts Ready to go! Once in use, it can be used for up to 28 days without refrigeration. To view full storage details, click here. NovoLog® FlexPen® lasts up to 28 days without refrigeration after first use, so it can be taken almost anywhere. Once in use, NovoLog® FlexPen® must be kept at room temperature, below 86°F. NovoLog® FlexPen® is disposable, so there is no refilling. When you run out of insulin, throw out your old FlexPen® and start fresh with a new one. Each NovoLog® FlexPen® package has 5 disposable insulin pens, for a total of 1500 units of NovoLog® insulin. Saving on NovoLog® FlexPen® NovoLog® FlexPen® is covered by most health care and Medicare prescription plans. You can get NovoLog® FlexPen® for about the same co Continue reading >>
How Long Should Insulin Be Used Once A Vial Is Started?
Editor’s comment: The commentary by Dr. Grajower has such important clinical relevance that responses were invited from the three pharmaceutical companies that supply insulin in the U.S. and the American Diabetes Association, and all of these combined in this commentary. The commenting letter and individual responses were authored separately and are completely independent of each other. Diabetic patients treated with insulin, whether for type 1 or type 2 diabetes, are prone to often unexplained swings in their blood glucose. These swings can vary from dangerously low to persistently high levels. Most diabetic patients, and most physicians, will adjust insulin regimens so as to avoid hypoglycemia at the expense of hyperglycemia. Among the “textbook” reasons for variable glucose responses to any given insulin regimen are 1) site of administration, 2) exercise, 3) bottles not adequately mixed before drawing the insulin (for NPH, Lente, or Ultralente), and 4) duration of treatment with insulin (1). A new insulin was marketed by Aventis Pharmaceuticals about 1 year ago, insulin glargine (Lantus). The manufacturer seemed to stress that patients not use a started bottle of this insulin for >28 days (2). Two patients of mine highlighted this point. L.K. is a 76-year-old woman with type 2 diabetes, diagnosed at 55 years of age, and treated with insulin since age 56. Her insulin regimen was changed to Lantus at night together with Novolog before meals. She monitors her blood glucose four times a day. She used a bottle of Lantus until it ran out; therefore, a bottle lasted for 2 months. Her recent HbA1c was 7.6%. I retrospectively analyzed her home glucose readings by averaging her fasting blood glucose levels for the first 15 days of a new bottle and the last 15 days of tha Continue reading >>
(pdf) Insulin Vials Vs. Insulin Cartridges: Further Cost Considerations
Abstract Scope: Many studies have provided evidence that favor the use of insulin pens over tra- ditional insulin vials due to lower overall costs. The cost of insulin in the Royal Medical Services in Jordan is subject to other considerations due to the favorable tender prices and the process of dis- pensing of insulin within the Royal Medical Services. Objective: To highlight further cost considerations associated with the wastage in the use of insu- lin vials and cartridges in the Jordanian Royal Medical Services. Methods: Two random samples were selected from prescriptions dispensed for diabetic patients using insulin in January 2012 from the outpatient pharmacy in Al-Hussein Hospital, King Hussein Medical Center, Amman, Jordan. First sample was selected from prescriptions of patients using vials; second sample was selected from prescriptions of patients using pens and cartridges. Average costs for insulin and wastage were calculated per patient from the Royal Medical Services perspective. Results: The average direct cost per patient using vials was JD 5.197 and for those using cartridges was JD 22.135. The average wasted quantity per patient in the rst sample was more than ten times that of the second sample. The cost of the average wasted quantity per patient in the rst sample (1.022 JD) was more than the double that in the second sample (0.441 JD). Conclusion: Although, the direct cost of insulin per patient by using vials was lower than car- tridges, there was a substantial reduction in the cost of wastage by using the cartridges in the Jorda- 2012 King Saud University. Production and hosting by Elsevier B.V. All rights reserved. Diabetes is difcult to control and treatment involves several approaches which are associated with different costs. In the Royal Medic Continue reading >>
Insulin Pens Vs. Vial And Syringe?
You have decided that one of your patients, a 72-year-old, should add a basal insulin dose to her antihyperglycemic regimen. During your discussion with her, she voices concern that between her “arthritic hands and poor vision” she won’t be able to accomplish this. You make the recommendation that using an insulin pen will make injection easier for her. Which of the following statements regarding insulin pens is true? A. They all require loading with an insulin cartridge. B. They have more accurate dosing than syringes. C. They can now dose insulin in .10 units increments. D. They are now available for all types insulin. Continue reading >>
Vials Or Cartridges ?
Member Type 1 since 1986, on pump since Jan13th 2007 I'm going on the pump Saturday (1\13) and I picked up my supply of Novolog today. I didn't realize until I got home that they gave me the cartridges instead of vials. I called my pump company and they said that I had to have vials, the cartridges would not work. So I guess I have to go back to my pharmacy and exchange the cartridges for bottles of Novolog ? Has anyone else had this experience with their pharmacy ? Do I need a new prescription ? I hope this doesn't delay my pump start date. Friend T1 since June 2006, pumping since October '06. You will probably need a prescription to get the vial instead. If the pump trainer is training you at the doctor's office, maybe they could give you a vial of insulin to start on and then write you a prescription that day. I would call and find out. I didn't know that a pharmacy would take something back once you've took it out of the store, but it won't hurt to try. I went and bought the Novolog pens right before my training session b/c I was almost out of insulin. I was thinking of injecting the insulin from the pens into an empty vial of insulin so that I could use it in my pump. I haven't tried it yet, though. I dont know but cant u syringe the stuff out of the carts to fill the pump up ?? D.D. Family T1 since February 1980, new to insulin pump. My pharmacy would take them back if they weren't opened. You could have your doctor call the pharmacy and change the prescription to vials. You might even get the pharmacist to call the doctor and have it changed. I'm getting my pump started tomorrow. My pharmacist told me I better come in and show it to him! (He's never seen one!) What doesn't kill you makes you stronger. Shouldn't I be invincible by now? Started Paradigm 722 on 1-1 Continue reading >>
Pens Versus Vials For Insulin Delivery: A Cost Comparison
San Francisco—Diabetes mellitus (DM) is the leading cause of kidney failure, nontrauma-related amputation of lower limbs, and new cases of blindness in the United States; it is also one of the most common causes of heart disease, stroke, and death. Type 2 DM (T2DM) is the most common form of the disease, affecting up to 7.9% of the US population. Estimated associated healthcare costs are $159.5 billion each year. Treatment guidelines emphasize the correct type of insulin at the correct time; according to researchers, the method used to deliver the insulin may also have an impact on patient outcomes. Previous studies have shown that patients prefer using an insulin pen rather than the traditional syringe and vial. __________________________________________________________________________________________________________________ RELATED CONTENT Over-the-Counter Insulin Available for Patients with Diabetes Who Cannot Afford Prescription U.S. FDA approves Medtronic's 'artificial pancreas' for diabetes ___________________________________________________________________________________________________________________ Researchers recently conducted a retrospective analysis to compare total direct healthcare charges and diabetes-related total direct healthcare charges among adults with T2DM who initiate therapy with mealtime insulin disposable pens or vials. They reported results of the analysis at a poster session at the AMCP meeting. The poster was titled The Association Between Use of Mealtime Insulin Pens versus Vials and Healthcare Charges in Patients with Type 2 Diabetes. The analysis compared the insurance claims of a nationwide sample of adults who initiated mealtime analog insulin therapy with a prefilled pen or conventional syringe and vial to assess the impact of th Continue reading >>
Two types of modern, pre-filled insulin syringes. An insulin pen is used to inject insulin for the treatment of diabetes. Insulin is a hormone produced by the pancreas. It is composed of an insulin cartridge (integrated or bought separately) and a dial to measure the dose, and is used with disposable pen needles to deliver the dose. It was introduced and marketed as NovoPen by the Danish company Novo Nordisk in 1985. Types of pens A number of companies make insulin pens including Novo Nordisk, Aventis, Eli Lilly and Biocon. These companies produce pens for most of their insulins, including NovoLog/NovoRapid, Humalog, Levemir and Lantus. There are two pen systems: durable and prefilled: A durable pen uses a replaceable insulin cartridge. When the insulin cartridge is empty, the empty cartridge is disposed of and a new one is inserted in the pen. A prefilled pen is entirely disposable. The pen comes pre-filled with insulin, and when the insulin cartridge or reservoir is empty, the entire unit is discarded. Most brands of insulin are now available for use in pens, these include: NovoMix, NovoRapid and Levemir by Novo Nordisk Lantus and Apidra by Sanofi-Aventis Humulin and Humalog by Eli Lilly and Company INSUGEN and BASALOG by Biocon Global Patient Uptake Insulin pens are used by 95% of insulin-treated patients in Europe, Asia, Australia and Scandinavia with excellent results. They are currently underutilized but growing in use in the United States. Insulin pens offer several significant advantages over insulin syringes: ease of handling, accuracy, and they are more discreet to use and easier to transport. To use an insulin pen How to prime an insulin pen. Screw or click on a new pen needle. If necessary, prime the pen to remove any air from the needle Continue reading >>
Insulin Vials Vs. Insulin Cartridges: Further Cost Considerations
Go to: 1. Introduction Diabetes is difficult to control and treatment involves several approaches which are associated with different costs. In the Royal Medical Services (RMS), after diagnosis of the disease and by excluding the regular visits to the clinics, the core costs incurred by the RMS in diabetes treatment can be confined to the cost of medications dispensed to patients and hospitalization due to diabetes complications. Many patients need insulin in the regimen of diabetes treatment. For outpatients, insulin can be administered by two main approaches: traditional vials and cartridges. In the RMS, both approaches are available; however, it is believed that adopting one of these approaches could be more cost-effective from the RMS perspective. Both types of insulin packages contain 100 IU/ml of biphasic insulin aspart. The vial contains 10 ml (1000 IU), while the cartridge used to refill the pen contains 3 ml (300 IU). Although, it is assumed that both approaches produce the same pharmacological outcomes, the ease of use and patient adherence have been compared widely in the literature (Baser et al., 2010; Bohannon, 1999; Rakel, 2009). The comparison between these approaches strongly favors the use of cartridges due to many reasons, for example, pens provide more accurate dosing, less pain due to smaller needle gauge, increased social acceptability and better quality of life (Bohannon, 1999); moreover, patient adherence was improved by using pens without significant increase in the cost (Baser et al., 2010). A study conducted in Mayo Clinic found that converting patients to insulin pens provided an overall cost savings (Ward and Aton, 2011). Another study, in the USA, found that overall annual health care costs were significantly decreased by starting or convert Continue reading >>
Misuse Of New Insulin Strengths. U 200, U 300, U 500 ...
We certainly have important education to accomplish with patients and health professionals regarding the new higher concentration insulin products that are available only in a pen, including U-300 TOUJEO (insulin glargine), U-200 TRESIBA (insulin degludec), and U-200 HUMALOG (insulin lispro). U-500 insulin is also available in a pen (HUMULIN), although vials remain on the market. Patients may not understand proper dosing and dose measurement with these higher concentrations of insulin products. From www.diabetesincontrol.com Nyhetsinfo www red DiabetiologNytt A patient who was previously using LANTUS (insulin glargine) U-100 was switched to Toujeo U-300. He was given pen needles to use with Toujeo, but at home, he decided to use the insulin pen cartridge as a vial. He drew up a dose with a leftover U-100 syringe, filling it to the 1000 unit mark, the same daily Lantus dose he had been taking. This resulted in a dose of 300 units of Toujeo, which led to hypoglycemia requiring hospital admission. Although the safety of using pen cartridges as a vial is questionable, health professionals who administer insulin have also used insulin pen cartridges as vials, sometimes even with hospital authorization. Using a U-100 syringe to measure higher concentrations of insulin could lead to a serious overdose, as in the above case. It is also a risk if insulin pump users take insulin from U-200 or U 300 and use in the syringe to the insulin pump, instead of ordinary insulin pump insulin 100 Units/ml With U-500, not only is there a risk of an overdose, but under dosing is also possible. In the past, many patients using vials of U-500 insulin measured their dose with a U-100 syringe but, used the syringe scale to measure only 20% of the actual dose. For example, 40 units on the U-100 sy Continue reading >>
Insulin Pens: Improving Adherence And Reducing Costs
The advantages offered by insulin pens may help improve patient adherence. Currently 8.3% of the United States adult population, or 25.8 million people, have diabetes. Of these cases, more than 90% are cases of type 2 diabetes mellitus (T2DM) and at least 1 million are estimated to be cases of type 1 diabetes mellitus (T1DM). Although a variety of oral medications are available for patients with diabetes, insulins remain an important component of treatment.1,2 Insulins are the standard therapy in patients with T1DM and are ultimately used in patients with T2DM who do not respond adequately to other treatment modalities. Although in some settings insulins may be administered intravenously (eg, with an insulin pump), the vast majority of insulin administrations are subcutaneous injections.1,2 Available Forms and Administration In the United States, 2 types of insulins are available: recombinant human insulins and insulin analogs. Recombinant human insulin is available from 2 manufacturers (Humulin by Eli Lilly and Novolin by Novo Nordisk); each of these is available in a regular form and in a longer-acting neutral protamine hagedorn (NPH) form. Unlike recombinant human insulins, insulin analogs are structurally modified forms of insulin that are designed to either lower blood sugar rapidly or maintain low blood sugar levels over time. These insulin analogs may be classified as rapid-acting and long-acting insulins. Rapid-acting insulins include insulin lispro, insulin aspart, and insulin glulisine, and long-acting insulins include insulin glargine and insulin detemir. Premixed formulations of insulin are also available.1,2 Regardless of the differences between insulin formulations, all conventional types of insulin can be administered subcutaneously. Subcutaneous injectio Continue reading >>
Tweet Insulin pens are common in the United Kingdom, and are generally characterised by a different shape and the fact that they use an insulin cartridge as opposed to a vial. Some insulin pens use replaceable cartridges, and others use non-replaceable cartridges and must be disposed of after being used. Most insulin pens use replaceable insulin pen needles, which have become extremely short and thin. The replaceable cartridges for insulin pens come in 3 and 1 ½ ml sizes, although 3 is more common and has become dominant. Prefilled insulin pens are disposed of when the insulin within the cartridge is used up. Prefilled pens are often marketed for type 2 diabetics who need to use insulin. Insulin Pens Browse through our list of insulin pen reviews. You can also buy the insulin pens from the Diabetes Shop. Simply click on an insulin pen name to read the guide. How do I use an insulin pen to treat my diabetes? Using a pen is a relatively easy process. Some pens require gentle shaking before use. Once the cartridge is loaded, screw on a needle and prime the pen to clear air. Then dial in the exact dose that you require to deliver the insulin to the body. What is good about insulin pens as opposed to syringes? Insulin pens are very easy to use. They are great for young diabetics who need to deliver insulin at school. Furthermore, many diabetics find insulin pens almost painless. They are also portable and discreet, as well as not being as time-consuming as syringes. An accurate dose can be pre-set on the dosage dial, which can be useful for diabetes sufferers who also have impaired vision. Why might I not like insulin pens? Insulin pens are not right for 100% of diabetes patients. Insulin in pens and cartridges is generally more expensive than bottled insulin and syringes. Continue reading >>
Mealtime Insulin Administration: Pens Versus Vials
Erik W. J. Kokkonen, MD; Scott A. Davis, MA; Hsien-Chang Lin, PhD; Steven R. Feldman, MD, PhD; and Alan B. Fleischer, Jr, MD Mealtime Insulin Administration: Pens Versus Vials Elizabeth L. Eby, MPH; Kristina S. Boye, RPh, MS, MPH, PhD; and Maureen J. Lage, PhD Mealtime Insulin Administration: Pens Versus Vials Elizabeth L. Eby, MPH; Kristina S. Boye, RPh, MS, MPH, PhD; and Maureen J. Lage, PhD The use of mealtime insulin via prefilled pens, compared with vials, was associated with improved adherence to insulin therapy and a reduction in A1C scores. Objective: To compare medication adherence, hypoglycemic events, and changes in glycated hemoglobin (A1C) levels among adults with type 2 diabetes mellitus (T2DM) who initiate therapy with mealtime insulin via 1) prefilled pens or 2) vials. Study Design: Retrospective cohort study. Methods: Data for this study were obtained from the Innovus InVision Data Mart database, from January 1, 2006, through June 30, 2010. Patients with T2DM who initiated mealtime insulin analogue via vials or prefilled pens were included in the study. Multivariate analyses examined the impact of insulin delivery on patient adherence, hypoglycemic events, and changes in A1C values, while controlling for patient characteristics, prescribing medication characteristics, and patient general health. Results: Pen initiation was associated with an 18.5% increase in the likelihood of having an adjusted medication possession ratio (MPR) of at least 0.80 (odds ratio [OR] = 1.186; 95% confi dence interval [CI], 1.065-1.320), a 6.9% increase in the adjusted MPR (P <.0001), and a 31-day increase in persistence (P <.0001). There was no difference between the 2 cohorts on the likelihood of having a hypoglycemic event (OR = .904; 95% CI, 0.755-1.082). For patients wh Continue reading >>
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 >>
Insulin Pens: Types, Benefits, And How To Use Them
Insulin pens are used by people with diabetes to inject insulin. The pens include an insulin cartridge, a dial to measure dosage, and a disposable needle. Insulin pens are growing in popularity. They allow insulin to be delivered in a more simple, accurate, and convenient way than the vial and syringe method. Contents of this article: Types of insulin pen There are several different brands and models of insulin pen available. Most fall into two distinct categories: disposable and reusable. A disposable pen: this contains a prefilled insulin cartridge. Once used, the entire pen unit is thrown away. A reusable pen: this contains a replaceable insulin cartridge. Once empty, the cartridge is discarded and a new one put in. A new disposable needle must be used every time insulin is injected. With proper care, reusable insulin pens can last for several years. Choosing an insulin pen The brand, model, and category of pen used will depend on several factors. It is important to discuss this with a doctor before purchase. Some general factors about the pen to consider include: type and brand of insulin available size of the insulin dose it can hold increments by which the dose of insulin can be adjusted material and durability (if reusable) how it indicates remaining insulin levels ability to correct dose levels that are put in wrong size of the numbers on the dose dial level of dexterity required to use the pen Benefits Research has highlighted the benefits of using insulin pens, particularly prefilled disposable pens. People with diabetes are happier using insulin pens than the vial and syringe technique, according to some studies. One reason for this is that insulin pens have many features that make them safe and convenient. For example, greater dose accuracy and autoshield ne Continue reading >>
Lantus Vial/vs. Cartridge/ Vs Solo Star
Just realized my vial of Lantus is reaching 2 mos. old. I keep it in the fridge in the original box. Throwing out a question about which type of container you order for your lantus and how often do you change it? Is it easier and more sterile to just buy the solo star pen and withdraw the insulin into the syringe from that instead of buying just cartridges? Can you get the insulin to come out of the cartridges/solostar easy enough? Are the cartridges/solostar glass like the vial? Do you keep them for shorter periods of time if they are plastic? Sorry if this question belongs under a different Board Index, thought I'd like the Lala land peeps to weigh in on this. DC has only been on Lantus for just over 2 months. Maybe someone with more experience will have more input than I do. I buy the package of 5 pen cartridges. They are glass just like the vial and I use a syringe. My last cartridge I used until it was totally empty which was about which was about 2 months. I keep the one I'm using in the fridge in a container with cotton padding surrounding it so it doesn't get moved as much. It is stored in one of the crisper drawers that doesn't get used as much and the temperature is more stable. The unopened cartridges, I just leave at the back of the crisper drawer in the box until I need them. The best before date is Nov 2012. The pharmacist told me they will keep fine as long as they are not opened. He also said I should be able to get at least 3 months out of the opened one as long as it's gently handled. There is really no difference between the pens and cartridges, except maybe price or availability. I usually use cartridges for up to 2 months, some people get longer, the same is true or the vial. The mfg. has only tested for 28 days so that is their recommendation. Whe Continue reading >>