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Diabetics, help with insulin injections

Discussion in 'Bad Dog Cafe' started by gitlvr, Jan 23, 2014.

  1. gitlvr

    gitlvr Friend of Leo's

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    Hi! I've been a type 2 diabetic for at least 15 years, but recently oral meds were not working, so my doc switched me to insulin.
    My doc went over how to inject(Humalog pen, 75/25), but he did it quickly and told me to go online for more information.
    I have been using the pen for 3 days, and it does not seem to be working. I upped my dose today, but my sugar is still high, and not coming down. I think I am injecting wrong.
    My doc told me to basically pinch an inch and inject the insulin there, between the fatty tissue and the muscle. Here is what I am doing.
    Roll the pen several times to distribute the insulin mix evenly(this is a mix of short and long acting insulin).
    Attach needle to end of pin.
    Dial up two units, hold the pen vertical and press the plunger to prime the pen. When I do this I don't get a stream of insulin, rather several drops that run down the needle. In order to get the pen to eject a stream I have to dial up at least 5 units, which to me is way more than what is indicated and wasteful. I have been youtubing this all morning, and the general consensus is that as long as some insulin is coming out of the tip of the needle the pen is primed properly.
    To inject, swab site, pinch up an inch of skin(thigh), and inject at an angle. Here is where I think I am making my mistake, and where I have questions.
    All the videos I see online show people pushing the syringe straight in, not at an angle, and all the way in.
    The needle on this pen is at least an inch and a half long. Everyone else
    's on line is very short.
    Since this is supposed to be a subcutaneous injection, not an intramuscular one, it seems to me that if I push that needle all the way in that it's going into the muscle, not between the muscle and the skin.
    Those of you that use this delivery system, or who use a regular syringe, which my doctor gave me a couple of pens and a vial and needles so I can try then both and see what works best for me, I would very much appreciate your experienced input with this.
     
  2. 0018g

    0018g Tele-Meister

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    I think I'd go back and clarify this with my Dr.
     
  3. Boubou

    Boubou Doctor of Teleocity

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    Yeah go see a doctor, not the uneducated people who think they know everything because they read a website once
     
  4. Telegator

    Telegator Tele-Afflicted

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    Yes indeed, see your doctor!

    I will say this though. I am on 18 units (Lantus) and I prefer the insulin syringe. Also for what it is worth my doc told me he would never go under five (5) units. Ask your doctor if somebody misread your prescription.
     
  5. gitlvr

    gitlvr Friend of Leo's

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    Thanks, but this is a simple subcutaneous injection that I'm certain many members here administer every day. I have to pay $75 every time I see this guy, and since he did not take the time to properly instruct me the first time I don't intend to give him a second shot at my wallet for something as simple as this. I am unemployed and do not have the cash. I am at this moment seeking a way to afford the insulin I need every month in the first place. But I did not start this topic to lament my personal financial situation, so that's all I'll say about that.
    Again, thanks for the reply. The advice is solid.
     
  6. Telegator

    Telegator Tele-Afflicted

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    If you are short on money maybe your local health unit can help you out. Sometimes a call to your doctor's office will put you in contact with his nurse.

    P.S.___ Doctor Office Nurses can be worth their weight in gold. Start buttering up yours immediatly. Candy and or donuts may be the place to start :idea:
     
  7. sunkidd

    sunkidd Tele-Holic

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    Get the shorter needle, Put in, alternating, stomach and soft part of legs...
    Straight in.
    Two units isn't much, just a couple of drops...
    If sugar isn't coming down your carbohydrates are to high...
    Look at the carbs you eat, they turn to sugar....
    Check with doctor if not continuing to work...
     
  8. Mjark

    Mjark Doctor of Teleocity Silver Supporter

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    Contact the people that make the pen.
     
  9. gitlvr

    gitlvr Friend of Leo's

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    Yeah, I'm currently exploring options.
    As to a nurse, my doc doesn't have one; just a couple of receptionists.
    He used to have a nurse, but I'm not sure what happened with her. I assume he is looking.
    I will try the straight in method. If I don't see results soon I will have to see the doc again. No choice. Fasting blood suger of between 250 and 300 is not acceptable.
     
  10. Warm Gums

    Warm Gums Friend of Leo's

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    I use two pen administered drugs from Novo Nordisc that both use the same (short) "needle" for subcutious admin. From what you are saying the pharmacy may have provided the wrong tips, inch and 1/2 sounds like something that would be used for a older type of insulin that was originally used with a manual draw syringe. If your MD is unwilling to help you with out a second charge, at least check with the pharmacist, (not a tech)they should do a consult and instruct for no charge. BTW mine primes w/several drops.
     
  11. gitlvr

    gitlvr Friend of Leo's

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    Thanks, Warm Gums! And the rest. Much appreciated!
     
  12. Warm Gums

    Warm Gums Friend of Leo's

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    I would also check with the pharmacist as to the possible availability of reduced price insulin based on your economic circumstances. Humalog lists such assistance on its site, but the information is limited to "healthcare professionals" which a pharmacist most certainly is. In my experience, they often have a better handle on the $ end of drugs than a MD, as the Pharm. deals with that end of things on a day to day basis.
     
  13. surfoverb

    surfoverb Doctor of Teleocity

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    most insulin syringes are 3-5/8ths of and inch.
    general rule of thumb is to use a needle half the size of the pinch (pinch an inch use 1/2 ") so unless the patient is really obese 1.5" sounds way too big.

    with normal sized needles we just pinch and go straight in, not at an angle. well, 90 degrees. and we dont aspirate or none of that just push that **** in fast (not crazy fast but not slow).

    they probably told you to go in at an angle because the needle is so long or you will end up in the muscle-you dont want that. all one needs is to get the med just beneath the skin (subcutaneous)

    insulin is absorbed at different rates depending on the site. abdomen is quickest, arms next, and most slowly is legs and buttocks. (unless one is an athlete)

    then always make sure to rotate the site.
     
  14. Norton72

    Norton72 Tele-Afflicted

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    I've been injecting insulin for about 5 years now. I use the Levemir Flex Pen which take very short needles. I always injected into my stomach. Pretty good amount of fatty tissue there. It usually takes me about 4 units to prime the pen. The instructions my doctor gave me were to start with 10 units, monitor my blood sugar, and increase by 4 units every four days until I hit my target. Still, you should consult a doctor for your circumstances.

    Here's an interesting thing you might consider. I have insurance, but initially my costs for insulin were quite high. I Googled "I cannot afford my insulin". The first link was to the Levemir site which gave me a $75 coupon. I took this to my pharmacist and my next prescription cost me nothing. Thereafter I have paid only $40 for five Flex Pens. I don't know how it worked out that way, but I don't question it. I buy a box of 100 generic needles for about $25. I don't know anything about the Humalog pens, but surely there must be shorter needles available. I went to the Humalog site and there was a link for 5 free pens. I didn't click on it, but you may want to check it out. You may be able to get a recurring discount like I did.

    Edit: Surfoverb is right. A pharmacist can make suggestions as to how to manage costs, much more so than a doctor.
     
  15. Slow Reflexes

    Slow Reflexes Poster Extraordinaire

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    Flex pens are great. Definitely check with the pharmacist.... that doesn't sound right at all. You should just be able to stab and hit the button. Butt, leg, waist, arm, wherever.
     
  16. surfoverb

    surfoverb Doctor of Teleocity

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    just a guess but i would think good old syringe and vial would be cheaper. youre paying for the simplicity/convenience of the pen, but drawing up and administering insulin with a trad syringe is stupid easy.
     
  17. studio1087

    studio1087 Telefied Silver Supporter

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    I'm not understanding the repeated priming or the emphasis on the stream or the pinch.

    When you use a new pen you're supposed to dial back for 2 units and plunge the pen (you waste 2 units).

    You don't need to shoot a stream into yourself. I don't think you can "shoot a stream" into yourself. Fatty tissue on your inside won't allow for a stream; you're simply injecting the insulin.

    Pinching part of your skin into a hard bulge and then sticking it with a needle sounds like a way to bruise yourself. I'm right handed. I stick myself in the right sight of my stomach (it's just ergonomics - right hand = right side of my tummy). The only constructive criticism I get from my doc is that I should try to change injection sites from left to right.

    I've been at it for about 15 years and my HA1C is 6.7 (good control).

    It sounds like you may have misunderstood some of the details (I say that with total respect to you). Call the nurses at your Doctor's office and review. I'm sure that everything will be fine. You're just getting started and you need some details.

    The pen can certainly dispense 2 units. It's just an insulin vial with a very accurate plunger on one end that pushes fluid out the other end. If you click the plunger to 2 you'll get 2. Who ever thought of combining a vial with a syringe was brilliant.

    Some people get nervous about needles but I believe that they make sense. I don't make my own insulin. Insulin is natural and organic and I'm simply adding it me. There's no side effects with insulin (I'm supposed to have insulin). When you start taking pills that put your kidneys or pancreas or liver into hyper drive to make up for excessive sugar levels you're doing something unnatural.

    Call the nurses. Ask some questions. You'll be fine.
     
  18. studio1087

    studio1087 Telefied Silver Supporter

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    You are correct. The pens offer simplicity. Being diabetic is a bit like wearing contact lenses. When you travel, you have to bring all the stuff. Ya gotta have your stuff! :eek:

    The pens simplify everything for the insulin user. It's really convenient.
     
  19. Warm Gums

    Warm Gums Friend of Leo's

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    It depends on the pen, even though mine are from the same firm, and use the same tips, the operation is slightly different. One is prime only on initial use, the other requires priming on every use, but requires only a token amout to prime.
    I don't do the pinching thing either, but I have seen equipment/meds that instruct that way.
     
  20. drmcclainphd

    drmcclainphd Tele-Afflicted

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    I'm type 1. I take 100 units of Lantis (slow acting) twice a day. I've got a medical background, both practice and education, and I studied up on this stuff plenty after being diagnosed.

    Do not make a large increase in dosage. That can cause insulin shock. Only increase in small increments (titrating, this is called) on a schedule your doctor specifies.

    TWO units? This sounds wrong. It sounds like two was the amount to increase your dose per day. 1.5 units of fast and 0.5 units of slow, not even with Metformin will that amount do much. Your first step is to double check with your doctor and get the correct dosage and titration figures.

    I use regular syringes, figuring the more mechanical something is the more likely to break down. Find an area of fatty tissue that's an inch thick or more and stick it straight in (needle is 1/2" x 30 ga. right?). I always use my belly, just switching sides and using different spots. If you've got such tissue thick enough, no need to pinch (which just inflames and makes it hurt, IMO).

    Dry the area after swabbing. Same with finger sticks. You can push alcohol into the puncture in either case causing it to interfere with the insulin as well as pain, or make your glucometer read way high.

    DO NOT let the doctor tell you "just read the web site". MAKE him instruct you. If you're doing it wrong now because he told you this, tell him so.

    Be aware that taking insulin and metformin at the same time can cause symptomatic gall bladder problems (green muddy stool and cramps). If so you'll likely need to quit metformin and increase insulin. But with your doctor's knowledge of course.

    If your injection stings, let it warm to room temperature first. We've been trying for decades to get dentists to stop leaving the novacaine etc. in the fridge because it doesn't need it, and it's the cold that causes much of the sting. Same for you. Your pen can sit out 24 hours and still be good. Of course if it needs it, one or two hours is plenty.

    AFTER going through this and making sure you're getting it right, realize three days is nothing. Expect 10 to 14 days minimum to stabilize on a dosage/sugar level.
     
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