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Why Do Insulin Syringes Vary

Factors That Influence The Characteristics Of Needles And Syringes Used By People Who Inject Drugs In Tajikistan

Factors That Influence The Characteristics Of Needles And Syringes Used By People Who Inject Drugs In Tajikistan

Go to: Abstract “Low dead space” syringes with permanently attached needles retain less fluid, blood, and HIV after use than standard “high dead space” syringes. This reduces the probability of HIV transmission if they are shared by people who inject drugs (PWID). The World Health Organization recently recommended that needle and syringe programs (NSP) offer clients low dead space syringes. The success of this recommendation will depend on PWID switching to low dead space needles and syringes. This paper examines the needles and syringes that PWID in Tajikistan use and factors that influence their choices. In May 2014, we conducted six focus groups in Kulob and six in Khorog, Tajikistan, with a total of 100 participants. NSP staff members recruited participants. Focus group topics included the needles and syringes used and factors that influence choice of needles and syringes. Focus groups were conducted in Russian and Tajik, audio recorded, transcribed, and translated into English. The translated files were imported into NVivo 10 for coding and analysis. All participants in both cities were male and reported injecting heroin. Everyone also reported using syringes with detachable needles almost exclusively. The most popular syringe sizes were 2 and 5 ml. Needles ranged in gauge from 25 to 21 g. Needle gauge was influenced by the size of the vein, the viscosity of drug solution to be injected, and problems with blood clotting. Needles ranged in length from 12 to 38 mm, with 25 and 32 mm being the most popular. Needle length was influenced by the depth of the vein being used. Many PWID inject volumes of fluid greater than 1 ml into deep veins that require needles at least 25 mm long and 25 g in diameter. Most low dead space syringes are 1-ml insulin syringes with Continue reading >>

Everything You Ever Wanted To Know About Injecting Insulin…

Everything You Ever Wanted To Know About Injecting Insulin…

But Didn’t Know to Ask Just take your shot. What could be easier, right? Well, you’d be surprised how many errors are made by “veteran” insulin users. It turns out there’s nothing basic about the basics of insulin injections. However, you can improve your technique. This article takes a look at the nitty-gritty details behind successful insulin delivery, why they matter, and how to avoid common pitfalls. The gear Realistically, there are two delivery systems when it comes to injecting insulin: syringes and pens. Yes, there are pumps, but that’s a whole other subject. And yes, there are jet injectors, but they are not widely used. Syringes. The first-ever human insulin shot was delivered by syringe in 1922, and here in the United States, more than half of all insulin is still delivered via syringe. Syringes used to be made of glass, had to be sterilized between uses, and had long, thick, steel surgical needles that could be resharpened on a kitchen whetstone. (No kidding.) But syringes have come a long way since then. Syringes are now disposable, the barrels are made of plastic, and the needles are thin, high-tech, multi-beveled, and coated with lubricants to make them enter the skin smoothly. (Bevels are the slanted surfaces on a needle that create a sharp point.) In the old days, the needle and the syringe were separate components. Nowadays most insulin syringes come with the needle attached. People who use syringes almost always purchase insulin in vials. Vials are glass bottles that generally hold 1,000 units of insulin. Pens. Insulin pens date from the mid-1980s, and while syringes still predominate in the United States, much of the rest of the world has traded in syringes for insulin pens. Pens currently come in two varieties: disposable, prefilled pens Continue reading >>

Do You Need A Prescription To Buy Diabetic Insulin Syringes?

Do You Need A Prescription To Buy Diabetic Insulin Syringes?

Diabetics use syringes to self-administer daily insulin injections. Each injection must be given with a new syringe for both safety from infection and for patient comfort. Syringes become dull and contaminated after a single use. A diabetic who uses insulin needs one or more new syringes per day, depending on her injection schedule. Prescription Requirements In the United States, prescription requirements for insulin syringes are set by each individual state. Some states require a prescription to buy insulin syringes, some don’t. In some states, notably Florida and Texas, individual counties may impose their own requirements. Laws regarding the purchase of syringes change from time to time, so check with the pharmacy you are planning to use. The pharmacist will know the local laws. Types of Syringes Diabetics use several types of syringes to prepare injections from bottled insulin. The most common is the U-100 insulin syringe. The notation U-100 refers to the number of units of insulin per ml of insulin. Diabetics also use mini pen needles, which are small needles that attach to insulin pens. When the mini pen needle is attached to the insulin pen, it is used to give an injection in the same manner as a traditional syringe. All types are subject to the same prescription laws. Buying Syringes Online When you buy syringes from an online pharmacy, the pharmacy will abide by the regulations of the state in which it is located. If you live in a state that requires a prescription for syringes and the online pharmacy is located in a state that does not require a prescription, you will be able to buy them without a prescription. Conversely, you will need to provide a prescription for syringes when you are buying from a state that requires them. Health Insurance Reimbursement Continue reading >>

Diabetes Care Tasks At School: What Key Personnel Need To Know

Diabetes Care Tasks At School: What Key Personnel Need To Know

Overall Goal: Student Health and Learning Following the insulin regimen is critical to student success. But just one piece of a comprehensive management plan. Glucagon Administration The training component is one of eight components created specifically for school nurses and non-medical school personnel who perform diabetes care tasks at school. These components include: Diabetes Basics Hypoglycemia and Hyperglycemia Blood Glucose Monitoring Insulin Administration Glucagon Administration Ketone Testing Nutrition and Exercise Legal Considerations This unit is Insulin Administration. Participants will learn: Types of insulin Insulin delivery basics Vial and syringe administration Pen device administration Pump basics Learning Objectives Our learning objectives include the following: Types of Insulin Insulin delivery basics Vial & syringe administration Pen device administration Pump basics Insulin in Schools Today Many students need to take insulin in school. Insulin regimens vary with each student and over time. Need for assistance will vary as the student progresses in self-management. GOAL: Maintenance of blood glucose target range. Not very many years ago, few students with diabetes took insulin injections at school. But now many physicians prescribe intensive insulin therapy for children that requires multiple daily injections to enable students to maintain blood glucose levels in target range. This is because studies have shown that this intensive treatment prevents or delays long-term complications of diabetes. Today many students will take insulin at lunch. Or when blood glucose levels are above target range. Regardless of when they need to take insulin, many students will need accommodations. Most older or more experienced students are capable of self-administrat Continue reading >>

Insulin Syringes

Insulin Syringes

If you have any questions about which insulin syringes to use, please post on Talking TR for assistance. The top photo is a U40 syringe which come with red caps and needles covers, and are also available with red unit marks. U40 syringes are made to hold 20.0u of U40 insulin or less, and are difficult to find with half unit marks. U40 insulin must be used with U40 syringes. We recommend using the syringe in the bottom of the photo which is a 3/10cc (ml) 100 syringe, for use with 30.0 units or less of U100 insulin. They have orange caps and needle covers. U100 syringes come with both full and half unit marks. Syringes with half unit marks make measuring the small increments given on TR much easier and more accurate. If from Europe, the description is 3/10ml, for 30 units or less, demi (descriptor for half unit markings). The cc and ml unit of measurement is the same. U100 syringes can be utilized with U40 insulin by using the conversion chart. Half unit marks make for much easier measuring of half and quarter units, as well as the "fats and skinnies" we use when dosing our cats on TR. Most vets do not support the use of U100 syringes with U40 insulin. Using the conversion chart for U40 insulin and U100 syringes, we are able to much more accurately measure very small increments of insulin. Most U40 insulin syringes do not have half unit marks, so accurate and consistent measuring of small doses is far more difficult. For more information, click here. The gauge of U100 syringes varies from 25 gauge (thickest) to 33 gauge (thinnest). The most commonly found 3/10cc syringes with half unit marks are found in gauges 29, 30 or 31. While a thinner gauge needle may hurt less during injection, the thinner the gauge, the more chance the needle may bend when giving shots. The needle Continue reading >>

Insulin Measurement Devices

Insulin Measurement Devices

(This article appeared in the VOICE OF THE DIABETIC, Vol. 11, No. 4, Fall 1996, published by the Diabetes Action Network of the National Federation of the Blind. Updated September 1997. We received many requests for this type of information, and, as much has changed, decided to run it again.) Most diabetics, blind or sighted, want and need to achieve control, independent self-management, of their diabetes. But if a diabetic cannot rely on vision to accurately measure insulin, then, to maintain independence, he or she MUST have effective alternative techniques, specifically designed for individuals with partial or complete vision loss. Many manufacturers have risen to the occasion, and with the appropriate adaptive equipment, non-sighted self-management is a reality. People's abilities (and ramifications) vary, and it is important to remember that different devices best meet different needs. Some diabetics, with fluctuating vision, will find that at certain times of the day they can rely on their vision to accurately measure insulin. At other times their visual acuity may diminish, leaving them guessing at their dose of insulin or relying on sighted aid. A diabetic's eye condition can change daily, making reliance on visual techniques unsafe. The following is a catalog of alternative devices for insulin measurement. Some are designed for those with partial sight. Others are intended from the start for non-visual operation. A few are the simplest of home-made aids, some designed by resourceful blind diabetics. NOTE: Prices quoted do not include shipping charges. Insulin Measurement Systems The Count-A-Dose: This insulin measuring device is manufactured by Jordan Medical Enterprises, 12555 Garden Grove Blvd., Suite 507, Garden Grove, CA 92643; telephone: 1-800-541-1193. Ca Continue reading >>

Alert Issued Over Withdrawing Insulin From Pen Devices

Alert Issued Over Withdrawing Insulin From Pen Devices

A national alert has been issued about the threat of severe harm and death from withdrawing insulin from pen devices. A Patient Safety Alert warning NHS providers about using insulin needles and syringes to administer the drug directly from a pen device or replacement cartridge has been released to avoid insulin overdoses. NHS Improvement has issued the warning about the dangerous practice after 56 incidents were reported to the National Reporting and Learning System (NRLS) between January and June 2016. The alert asks healthcare providers to ensure staff have access to appropriate equipment and training for administering insulin using a pen device by 11 January 2017. It states: “Patient safety concerns have been identified where healthcare professionals use an insulin syringe and needle to withdraw medication directly from a patient’s insulin pen device. This practice should not happen as the strength of insulin in pen devices varies, creating a risk of overdose if the strength is not taken into consideration when determining the volume required. “Reports suggest this practice has occurred where staff have not had access to equipment for safely disposing of needles attached to pen devices, and/or lack training in the use of insulin pens.” Although the strength of insulin was previously standardised at 100 units/mL, this can vary in pen devices, currently by multiples of 100 units/mL. Pen devices can be adjusted to take account of this variation and ensure the correct dosage is delivered. The dose is set on the pen’s dial and the device automatically determines the volume it delivers. A spokesman for NHS Improvement added: “If people with diabetes are unable to use their pen device as normal, they may require a healthcare professional’s help. Where this ha Continue reading >>

Diabetes: Drawing Up And Giving Insulin

Diabetes: Drawing Up And Giving Insulin

Learning to draw up and give insulin takes practice. Families often start by doing "air" shots into a doll for practice. Next they practice drawing up sterile salt water (saline) and injecting each other. This helps family members realize that the shot is not very painful. Children below age 10 usually do not draw up insulin by themselves as they do not have the fine motor abilities and concern for accuracy. Your child will need your help. What kind of syringe should we use? There are now several brands of disposable insulin syringes with varying needle widths. Needle thickness is measured in gauges. A larger number means it has a thinner needle (for example, a 30 gauge needle is a thin needle). Needles also come in varying lengths. The standard length is 1/2 inch. Insulin syringes should have thin, short, sharp needles so they are easy to insert. The amount of insulin a syringe will hold varies. Insulin is measured in units. Example of common syringes: 3/10cc (holds 30 units) 1/2cc (holds 50 units) 1cc (holds 100 units) Syringes have markings on the side that measure the units. A 3/10cc syringe has a larger distance between the unit lines and is easier to use if you need to measure small doses. There are even some syringes that have markings for half units. If you do not want to throw away the syringe after each use, you can reuse it. However, the needle may get dulled from going through the rubber stopper on the insulin bottle over and over. A dull needle may cause more damage to your child's skin and tissues. There is also a possibility of infection when reusing syringes. How do I draw up the insulin into the syringe? Your healthcare provider will show you how to draw the insulin into the syringe. These are the steps: Get your supplies (syringe, insulin, alcohol) and Continue reading >>

Insulin: The Holy Grail Of Diabetes Treatment

Insulin: The Holy Grail Of Diabetes Treatment

Insulin is a hormone made by beta cells in the pancreas. When we eat, insulin is released into the blood stream where it helps to move glucose from the food we have eaten into cells to be used as energy. In people with type 1 diabetes, the body produces little or no insulin as the cells that produce insulin have been destroyed by an autoimmune reaction in the body. Insulin replacement by daily injections is required. In people with type 2 diabetes the body produces insulin but the insulin does not work as well as it should. This is often referred to as insulin resistance. To compensate the body makes more but eventually cannot make enough to keep the balance right. Lifestyle changes can delay the need for tablets and/or insulin to stabilise blood glucose levels. When insulin is required, it is important to understand that this is just the natural progression of the condition. RMIT University have produced a short overview of insulin, a drug that keeps in excess of one million Australians alive. Watch the video to understand why insulin is important and why so many Australians rely on it to stay alive. Copyright © 2015 RMIT University, Prepared by the School of Applied Sciences (Discipline of Chemistry). At this stage, insulin can only be injected. Insulin cannot be given in tablet form as it would be destroyed in the stomach, meaning it would not be available to convert glucose into energy. Insulin is injected through the skin into the fatty tissue known as the subcutaneous layer. You do not inject it into muscle or directly into the blood. Absorption of insulin varies depending on the part of the body into which you inject. The tummy (abdomen) absorbs insulin the fastest and is the site used by most people. The buttocks and thighs are also used by some people. While i Continue reading >>

Don’t Ask Me, Ask The Expert!

Don’t Ask Me, Ask The Expert!

I am no medical expert, but I love learning about different aspects of diabetes from people who are. I also love listening to the questions that people ask health care professionals. No, I haven’t hidden microphones in your doctor’s office, but I do find any medical Q&A session to be a great learning opportunity. Why? Because sometimes the questions asked are related to something I’ve been wondering about and other times the questions are something I would never have considered before. Does this type of curiosity seem strange? Give it a try and check out the American Diabetes Association’s Ask the Expert section on diabetes.org, where people from all over submit their questions. If selected, the questions are answered by an expert and posted here. I scan the questions from time to time and found a few to share with you today: Question When you are pre-filling insulin syringes, is there a time limit for how far in advance they should be pre-filled? Answer Insulin syringes are only approved by the FDA for immediate use, not for pre-filling. When mixing 2 types of insulin in a syringe, it is best to inject the mixture immediately. Becton Dickinson (BD), a manufacturer of insulin syringes, does not recommend the use of their syringes for anything other than immediate use. In addition to multidose vials, many manufacturers package their products in pre-filled pens, and pens with pre-filled, replaceable insulin cartridges with disposable needles. This packaging eliminates the need to draw up insulin into a syringe. Question I take 1500 mg of metformin a day. When is the best time to take it? Answer Regular-release tablets of metformin are usually dosed twice a day with meals. If you have been prescribed the extended-release tablets of metformin, the dose is usually ad Continue reading >>

How To Inject Lantus® With A Vial And Syringe

How To Inject Lantus® With A Vial And Syringe

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 needles, insulin pens, or syringes with others. Do NOT reuse needles. Before starting Lantus®, 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 breast-feeding or planning to breast-feed. 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 already have heart failure, it may get worse while you take TZDs with Lantus®. Your treatment with TZDs and Lantus® 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: Sudden weight gain Tell your doctor about all the medications you take, including OTC medicines, vitamins, and supplements, including herbal supplements. Lantus® should be taken once a day at the same time every day. Test your blood sugar levels while using insulin, such as Lantus®. 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. Do NOT dilute or mix Lantus® with any other insulin or solution. It will not work as intended and you may lose blood sugar control, which could be serious. Lantus® 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. While using Lantus®, do not drive or operate heavy machinery until Continue reading >>

Insulin Syringes

Insulin Syringes

Tweet Insulin syringes were the only commonly used way of delivering insulin for much of the 20th century. Towards the end of the 1990s, insulin pens became more commonly used. Whilst less popular these days, syringes are still in use by people with diabetes Length and gauge of insulin syringes Insulin needs to be injected subcutaneously, that is into a layer of fat between muscle and the skin. Insulin syringes are available in a number of needles lengths. A short length of needle would be less than 10mm A longer length of needle would be over 10mm long Your health team can help to advise over which length of needle may be best for you. The gauge (width) of insulin syringes tends to be slim because of the regularity at which injections of insulin are taken. U-100 insulin syringes The markings down the side of the syringe shows how many units of insulin are in the syringe. NHS Diabetes states that, in the UK, insulin is only available to humans as U100 insulin. This means that there are 100 units per 1ml of insulin. U100 insulin syringes therefore give the correct unit markings for U100 insulin. In rare exceptions, patients may take U500 insulin. This insulin has 5 times the concentration of standard UK insulin. Beware that insulin from abroad may have a different concentration to UK insulin. Mixing insulin in a syringe Syringes allow for two different types of insulin to be mixed. Only certain insulin can be mixed. Do not mix insulin unless your health team have advised you to do so. Use and disposal of insulin syringes Insulin syringes these days are for single use only. A specialist sharps clipping device can be used to remove the needle before the syringe is disposed of. Syringes should be disposed of in a dedicated sharps container to prevent any risk of contracting Continue reading >>

Do I Need A Prescription To Get Insulin Syringes?

Do I Need A Prescription To Get Insulin Syringes?

Insulin, a necessity for diabetics to regulate their blood sugar levels, cannot be taken orally as the body digests it before it can be sufficiently absorbed into the bloodstream. This led to the development of syringes specifically designed to administer the proper dose of insulin. Since most insulin must be administered at least once a day, diabetic patients need to purchase insulin syringes so their insulin injections may be performed at home. Types of Insulin Syringes There are numerous brands of insulin syringes which are disposable, and that come in varying lengths and sizes. The gauge or size of the needle varies, with a higher gauge number indicating a thinner needle. The U-100 is the most familiar and commonly-used syringe for insulin. The U-500 insulin dosage requires a tuberculin syringe. If U-40 insulin is required, there is a U-40 syringe available although it is not sold in the United States. Prescription Requirements for Analog Insulin Syringe The need for a prescription to purchase both insulin and supplies, such as insulin syringes, depends on the type of insulin needed. There is a newer type of insulin, called analog insulin, which acts quicker and lasts longer. Humalog, Lantus, Novolog and Apidra are some common brands of analog insulin. All states require a doctor's prescription in order to buy any brand of analog insulin and accompanying syringes. Prescription Requirements for Older Insulin Syringes There are specific state prescription requirements for older types of insulin and syringes. Certain states do require a prescription to purchase insulin syringes, with notes on each as applicable. For instance, when buying syringes in Alaska or Connecticut you are limited to 10 days worth; Delaware, Florida and Illinois only require a prescription if you Continue reading >>

What Size Insulin Syringe Should I Buy?

What Size Insulin Syringe Should I Buy?

Insulin syringes come in several sizes. When buying syringes, keep these things in mind: Needle gauge: The gauge of the needle means its width, or thickness. Insulin syringes range from 28 gauge to 31 gauge, and the larger the number the smaller the gauge. (An Ultra-Fine II brand needle is the smallest, and the Ultra-Fine is the next size up.) Smaller, thinner children may do well with the smaller gauge needle. Some older and larger children may prefer the larger needle. Needle length. Common needle lengths are 12.7 mm (1/2") and 8 mm (5/16"). The 8-mm needle is called "short" and is the length that most people prefer. Barrel size: The barrel size determines how much insulin the syringe can hold. Buy a barrel size that best matches your standard insulin dosage. For example, a 3/10-cc syringe is best for 30 units or less, 1/2-cc syringe is best for 30 to 50 units, and a 1-cc syringe is best for injections of 50 to 100 units. To make sure you have the size you need, always check the box before you leave the pharmacy. When you draw up insulin, look closely at the markings on the barrel, especially whenever you change syringe sizes. The markings will be different, and you need to make sure you're drawing up the right dose. Continue reading >>

All About Injections

All About Injections

A healthcare professional trained in injection techniques can teach you how to do it right The following recommendations apply to people with diabetes being treated with insulin injections or GLP-1 analogues (albiglutide (EperzanTM), dulaglutide (Trulicity®), exenatide (Byetta®), exenatide sustained release (Bydureon®) and liraglutide (Victoza®)). They are based on the Recommendations for Best Practice in Injection Technique (2015) from the Forum for Injection Technique (FIT). Preparing for injection Follow these important steps before an injection: Wash your hands and the injection site with soap and water, and dry well. If you use an alcohol swab (e.g.: in a hospital), let the skin dry completely before administering the injection. Check that the vial or cartridge has not passed its expiration date. Wipe the cartridge or vial with an alcohol swab. When using cloudy insulin, gently roll the cartridge, vial or pen device 10 times, then tip it (do not shake) 10 times. Finally, inspect it to ensure that the suspension has a consistently milky white appearance. Is a skin lift necessary? In adults, a skin lift is used in some situations, based on needle length and the amount of adipose (fat) tissue. A skin lift should be used when the needle is 8 mm or longer. In addition, in people whose arms and legs or abdomen have little fatty tissue, a skin fold might be justified when using a needle of 5 mm or 6 mm. A skinfold may not be necessary especially when using a 4 mm needle . A skin lift, if required, must be done properly to ensure that the medication is not injected into the muscle or not deeply enough. Injection areas In adults, the recommended injection areas are the following: abdomen thighs upper buttocks back of the upper arm (not a preferred area because of the di Continue reading >>

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