Syringe Q's for First Time Switch to Lantus

[Alex1313]

I just gave Henrietta her first Lantus injection, switched from ProZinc. I'm now using 1/2" 29g u-100 syringes. The unit markings on these u-100 syringes are INSANELY small. I realize I can get some with half unit markings but have no idea how I would even see that because I can barely see the 1 unit mark. I've got excellent vision too, it's just so incredibly small. How the hell do you get an accurate dose at one unit? I'm terrified that negative pressure is going to be an issue after I've depressed the plunger with the needle under her skin and it will just suck that small amount of insulin right back up so I kept the plunger pressed as hard as I could until I got the needle back out of her skin. Do the syringes come in any different size, like more narrow so the unit markings are further apart? Also I'm having a hard time finding the u-100 in a larger gauge such as 30 or 31 AND with half unit markings. Does anyone have a preferred brand for that reason? Also, I watched the Lantus videos in the sticky here and elsewhere on the internet and they all mention making sure there are no air bubbles. How do you do that with such a tiny amount of insulin? And how do you draw up just a unit, it's almost impossible to draw just one unit up so it seems like I'll be wasting a lot of insulin drawing up way more than she needs then ejecting it onto a towel to adjust it down to her dose as the videos here make mention of not putting it back into the vial. I can't seem to draw less than three units with the smallest of movement with the plunger on my part. All the info you have here will be helpful as I'm very worried about dosing her properly now. Thank you.

 

[Rosie & Bailey]

Welcome to Lantus and Levemir Land!

I don't an answer for all of your questions, but I will share what I can. I'm sure you will get many responses. This board is very helpful and supportive.

The unit markings on these u-100 syringes are INSANELY small.

Yes, they are. A lot of people on here use magnifying glasses or reader glasses. I use an old kid's microscope.

Also I'm having a hard time finding the u-100 in a larger gauge such as 30 or 31 AND with half unit markings.

I use Walmart's ReliOn 31 guage, 8mm length syringes. Never used anything else so I can't comment on any comparisons. Something I learned fairly recently is that the syringes, regardless of brand, are not consistent in their markings. Several folks use calipers to make sure they are getting consistent dosing. There is more information in this link here:
http://www.felinediabetes.com/FDMB/threads/dosing-with-calipers-updated-w-videos.79851/#post-874756

I had a hard time using calipers so I separated my syringes so that I always used ones that had the zero line in the same place everyday. I am now adjusting in the way I measure so that I can use the rest of the syringes. You'll find the method that works best for you, but I did want to make you aware of that.

I can't seem to draw less than three units with the smallest of movement with the plunger on my part.

You'll get the hang of it.

Here are the steps I follow in getting the syringe ready. I had been having trouble getting rid of bubbles. Plus, my vet had originally told me to withdraw the insulin with the syringe, then to push back any extra into the pen. That is not a good idea due to risk of contamination. Additionally, be sure to store the insulin in the refrigerator, not in the door to the fridge. These are all mistakes I've made.

The steps:
1. Slide the plunger up and down the barrel a few times to take advantage of the lubricant on the inside of the barrel.
2. Push the plunger up to the top as much as I can before inserting into the pen.
3. Draw up insulin with a bit extra to make up for possible air bubble.
4. Pull back on the syringe pretty far down(20 or 25 mark) so that all the air accumulates at the top and all the insulin consolidates at the bottom.
5. If there are any air bubbles in the insulin, flick the syringe. The insulin will splash all over the sides of the syringe.
5. Slowly push the barrel back up, picking up all that insulin that was splattered on the sides of the syringe.
6. Continue to push up slowly until the air is all released.

**Step 4 is where you can see how much insulin you have in the syringe.

Hope this helps.

 

[Alex1313]

Welcome to Lantus and Levemir Land!
Several folks use calipers to make sure they are getting consistent dosing. There is more information in this link here:
http://www.felinediabetes.com/FDMB/threads/dosing-with-calipers-updated-w-videos.79851/#post-874756

I had a hard time using calipers so I separated my syringes so that I always used ones that had the zero line in the same place everyday. I am now adjusting in the way I measure so that I can use the rest of the syringes. You'll find the method that works best for you, but I did want to make you aware of that.

WOW. None of this was an issue with the Prozinc. This is insane. There 20 animals here (rescue group) and I can barely get up in time to clean, medicate and feed everyone before work. Now I have what appears to be a quite complicated procedure just to get the correct, tiny amount of insulin into a syringe at the worst possible time, i.e. when I am rushed and trying to wake up. I absolutely want to give Henrietta the best care possible...just overwhelmed by what a process getting the insulin out of the bottle and into a syringe is.

 

[Rosie & Bailey]

Now I have what appears to be a quite complicated procedure just to get the correct, tiny amount of insulin into a syringe at the worst possible time, i.e. when I am rushed and trying to wake up.

Definitely sounds like you have your hands full, but it will get easier over time. It's overwhelming for everyone at first. i also threw a lot at you at once so sorry about that.

Since you are starting off with 1 unit, it shouldn't be too bad in the beginning. The calipers come in handy when you have to make .25 unit adjustments, which hopefully you will have to if and when her insulin needs decrease. The readers or a magnifying glass will come in handy, and many people have a light desk or they hold the syringe up to the light to be able to see the lines better.

Hopefully, more people will post with more tips to make it easier for you.

What kinds of animals are in your rescue group?

 

[Amanda and a Loudogg]

I had the same issue. Lou was originally on Vetsulin, which used U40 syringes. I had it easy there compared to the itsy bitsy U100 syringes. I personally haven't found a wider syringe yet. I use CarePoint 31G 3/10 syringes w/half unit markings from ADWDiabetes found HERE. I generally don't have a lot of bubble issues with my syringes, but I found the secret to drawing up the right dose was to draw slower. I always went pretty quick with the Vetsulin, because you could inject the insulin back in if too much. I found I just had to go slower and really visualize where I wanted to draw the dose. So I'd look at the syringe, and then draw it up slowly to the line. If I draw a bit too much, I just inject out the drop onto a napkin or something. It was stupidly hard at first, but it truly got easier with practice. I have struggled with .25/.75 doses as well, but the key here is consistency. Figure where you think the .25/.75 should fall and go with that. Giving a consistent dose is more important than making sure you are giving an exact amount of insulin.

 

[Alex1313]

Definitely sounds like you have your hands full, but it will get easier over time. It's overwhelming for everyone at first. i also threw a lot at you at once so sorry about that.
...
What kinds of animals are in your rescue group?

I appreciate all the info and am not overwhelmed by that but rather with what a ridiculous method one has to resort to in order to dose a cat with this insulin. I can see how many, if not most, people would not go to these lengths for their cat, based on my experience with the general public. It seems like making a different syringe for such a small dose would sell well for veterinary use and don't understand why one has not been created.

Most all of the animals here are community cats that could not go back to their outdoor homes.

 

[Alex1313]

I had the same issue. Lou was originally on Vetsulin, which used U40 syringes. I had it easy there compared to the itsy bitsy U100 syringes. I personally haven't found a wider syringe yet. I use CarePoint 31G 3/10 syringes w/half unit markings from ADWDiabetes found HERE. I generally don't have a lot of bubble issues with my syringes, but I found the secret to drawing up the right dose was to draw slower. I always went pretty quick with the Vetsulin, because you could inject the insulin back in if too much. I found I just had to go slower and really visualize where I wanted to draw the dose. So I'd look at the syringe, and then draw it up slowly to the line. If I draw a bit too much, I just inject out the drop onto a napkin or something. It was stupidly hard at first, but it truly got easier with practice. I have struggled with .25/.75 doses as well, but the key here is consistency. Figure where you think the .25/.75 should fall and go with that. Giving a consistent dose is more important than making sure you are giving an exact amount of insulin.

That makes sense and is helpful. Thank you.

 

[Alex1313]

So of course I found a better syringe and it has been discontinued so I can't order them. The Terumo u-100 1/2cc have much clearer markings and are generally easier to use. I had a couple that were donated to us and thought I could just order these and have my problem solved but, no, they have been discontinued and I cannot find them anywhere. Ugh

 

[Rosie & Bailey]

. It seems like making a different syringe for such a small dose would sell well for veterinary use and don't understand why one has not been created.

I agree wholeheartedly.

So of course I found a better syringe and it has been discontinued so I can't order them.

You seem pretty determined. If you find a better syringe, please share. I know all of us lantus users would appreciate it!

 

[Chris & China (GA)]

All these syringes have half unit markings (very important when you're doing microdosing) and are the correct syringes for U100 insulin and are available from ADW online:
UtiCare
Monoject
Carepoint
Sure Comfort
B/D

They're also available at WalMart if you have one near you. Their Relion brand 3/10ml, 30 or 31 gauge, 6mm or 8mm insulin syringes all come with half unit markings and are only $12.58 for a box of 100 (although a lot of them don't realize they DO come with half unit markings!)