3/4 Insulin Syringe Accuracy

Status
Not open for further replies.
Marje and Gracie

Marje and Gracie

Member Since 2010
Moderator
As many of you know and also experience, syringe accuracy for our microdosing is a "challenge". For a couple months, I've been in touch with Can Am who makes and distributes Monojects. I've found that the zero
line in the U100, 31g, 3/10cc, short needle, half unit marking syringes is extremely variable and for a kitty like Gracie, even a tiny drop off makes a difference. Can Am had me send them samples of the inaccurate
syringes and they came back with the justification that their syringes meet ISO standards and the allowable variation. I asked them to send me those standards as well as who the regulatory agency is for insulin
syringes. Supposedly, they are sending me this information in a "formal" letter....I'd be happy with an email.

I just ordered three boxes of the above syringes from ADW and of the 300 syringes, only 75 were even close enough to accurate for me to use. They are sending me a box to ship the affected ones to them so they
can check them out again. I did notice that when I ordered a box from Hocks, even though they were the same lot numbers as my last order from ADW, the syringes from Hocks were much better. I can't figure that
one out. But from now on, I am ordering from Hocks.

Note: they do think this is all in reference to a child since I know they would not be responsive if they knew it was a feline.

At any rate, I did take all their suggestions including speaking with a human diabetes counsellor who is on their advisory board. He tells me he has been pushing them for quite some time to make a pediatric syringe that holds
3-5 units and has .1 unit markings. Of course, that would be great. I asked Can Am about it again this week. They said they are looking into developing a pediatric syringe. They do not know how long it will take but
it has been a big discussion topic of late.

The other information they gave me is about a mini syringe developed in Sweden. The website is: Insultion Syringes. I'm not sure these would work for us and they are not available
in Canada or the US. I emailed the company, they have not yet responded. They are available in Australia.

I will continue to keep you all posted. I did go buy a box of the new Relions but the lines were so thick and blurry and inaccurate, that I took them back. I do like the MJs as I don't get any bubbles in them. BDs...too many bubbles and
inaccurate, Terumos...really inaccurate, Ulticare...didn't care for these either...unit markings seemed inconsistent.

If anyone wants to add anything or suggest anything....I am ALL EARS :lol: :lol: :lol: :lol:
 
Hi Everyone,

I had just the opposite experience with boxes of MJs from Hocks and ADW: My box of MJ 31 gauge syringes from Hocks had lots and lots of inaccurate ones. In fact, I finally resorted to setting it aside and going to a new box. This new box (different lot number, however), which is from ADW, is much, much better.

The pediatric syringe sounds like a fantastic idea. And since it would be intended for children, I'll bet that the quality control would be better.

Thanks, Marje, for looking into this.

Ella
 
it's a problem. i don't know the solution, but i agree.

re the companies - when i switched to the confirm relion, i contacted ADW to see about sending back the 2 boxes of Freestyle Lite strips that i had not yet opened. they said i was over the 30 days (by about 10 days, because i had bought 6-8 boxes of the strips at once) and they would not take them back. i said they could take them back or i would shop elsewhere. they said a manager would call me. no call. that's been 2 weeks now. those 2 boxes are worth about $70 and i am stuck with them. like all of you, i'm spending a couple hundred a month on supplies and i buy most of it from ADW.

so . . . fwiw, i'm going back to Hocks.

also on the terumo - i had used them initially buying them first from the vet at $1 per syringe, then online from another source, not ADW or Hocks. i would have to go back to find out where, might've been medi-vet. they didn't have .5u markings. the ones i bought previously cost considerably more than the ones from ADW. The ones from ADW were about $11 or $13, i think, and the ones i bought before were $25ish. i'm wondering if ADW buys second quality and if that's how they are selling them so much cheaper than everyone else.

i'm a quilter and i know that manufacturers will run the identical looking print designs on different qualities of fabric, designed especially to be able to sell cheaply because that's what most people want. the fabric will look identical, carry the same manufacturer's name on it, but the actual fabric quality will vary according to what you pay for it. an expensive fabric will have finer hand (texture), more threads per inch, it won't wrinkle, it won't have flaws in the thread that can cause runs, etc. the cheaper will look the same but it won't hold up as well. fabric purchased at JoAnn Fabrics or Hancock's is not the same quality as the fabric purchased at a local quilt shop.

this issue with the syringes has made me wondering if the same process happens with them.
 
I also complained last June to ReliOn and sent them 3 samples. One had the zero mark up at the top, one had the zero mark about 1/4 unit down, and the third had the zero mark about 1/2 unit down from the top. I was working through my WalMart Pharmacy who know the syringes are for my cat. But the ReliOn company sent me a bunch of packaging (all of which said Bio Hazard or something like that on it) to send the syringes to them. They also said that the syringes were within guidelines and gave me a free box. I didn't want the free box, I wanted the problem fixed.

At the beginning of last week, I opened a new packet of syringes that had the zero line right at the top, most of the ReloOn syringes I use do not. So, I'm thinking, when I measure the dose using this syringe, I'm basically giving a reduction, because the insulin will be less, but I will still write 1.00 unit on my spreadsheet.

I have in the past marked on my spreadsheet the times when I am using syringes that are "off" and when I went back to using "normal" ones. It is a hassle, though. I hope they do come out with the baby syringes with 0.1 unit marks.
 
Ella...that is interesting! I know Sienne gets her MJs from Hocks and said she has not had a problem. I forgot to add that the free syringes that Can Am sent me were as bad as the ones from ADW :? :? :shock:

Julie: excellent point. I know I can order MJs from CVS or Walgreens...for $30/box. But if I'm unable to use 3/4 of a box that I paid $13 for, but could use ALL of the $30/box syringes...I'd come out ahead n'est-ce pas?
 
Wow, Marje, thanks for the info on all the syringe accuracy. I use BD syringes and I have to pull the insulin really fast in order to not get bubbles, and of course pull more then I need to shoot out the bubbles when I get them. I figured there aren't any perfect syringes out there, but the really funny thing is, just last night, I had a conversation with DH, and he asked me if they make pediatric syringes, and thought probably not, but I guess he was on to something. I wondered, because maybe there aren't enough baby's that are diabetic…??
 
I've been using the Relions lately and have found the box i have to be very consistent. The lines are thicker, but I've learned to eyeball them fine. The zero is always even with the plunger when it's pushed all the way in, while the MJ's was not, and for me, the MJ's drew so much more air than any other brand, which caused the dose to be drastically different when I'd test it; sometimes it was normal, sometimes just a tiny drop, obviously not the full .25 dose. I like the BD's also, but they cost $20 more per box of 100 than the Relions. Ouch!
 
in other words - it seems the very same brand can be inconsistent from box to box and from syringe to syringe within the box.

do you have another conversation planned with any manufacturer, marje? i would be curious to know if they do different runs for different price points, or if the syringes are sorted and sold by quality.

heehee love the french!
 
That child size syringe would be heaven sent! Thanks for pursuing this, Marje.

I haven't had the problem Marje has had w/ the Monojects from ADW as opposed to Hocks. I would guess that it was more a batch problem since the two purchases would have been made at different times. I have had a few (∴12 out of a box) syringes that were off, more because the plunger fit (it let insulin leak behind the plunger) than the lines. I compensate for the lines because w/ Tess's small dose I can count out the entire dose in drops and adjust on the redraw if it is off.

Marje, are you talking about the number on the box or on the individual syringe wrapper? The # on the box is the model or SKU #. The number on the wrapper is the lot #.

Does anyone remember who it was that was using a reusable syringe w/ disposable needles about a year ago? It was a glass syringe w/ very fine markings. That may be the way to go. Any disposable product is much more prone to mfg vagaries than a permanent one.
 
ME AND BD SYRINGES cat(2)_steam cat(2)_steam cat(2)_steam
I have been fighting with BD for 4 years about the printing of the lines on their syringes!!!!
Obviously this is an issue with all of us, regardless of what we use!!
Only Good thing is that when I find misprints from them, I call up, get a FREE BOX of syringes, and return the bad printed ones to them in a secure package that they send me...
This goes on at least twice a year and they know me well!
I totally know what you are all saying,
Our babies are very delicate & we need to treat their shots that way!!
I have explained this to BD a hundred times, and they claim they understand, yet
it still goes on!!
Oversized lines, crooked or slanted lines--Makes me think it's my eyesight!! :lol:
Hope someone somewhere will remedy this!
 
Ann: it's the lot number that is on the syringe packages but it's also on the back of the box at the top....it matches the syringe package. In this last lot number of the three boxes I got, the plungers are different thicknesses as well and some of the syringes are cloudy...I'm assuming due to the silicon but it makes it difficult to see the unit marks. And I'm using a 3X lighted LED magnifyer. I do remember there was someone...seems like it was some guys wasn't it?

Julie: this next week we are supposed to talk again. Merci beaucoup!

Roni: I have read your issues with BD before and I think it's great they send you free syringes because when I mentioned it to Can Am, they said "well we didn't mind replacing the first three boxes but we can't just supply you with syringes for free". REALLY? I was only asking them to replace the ones I PAID for and have a receipt for!
 
de rien! ;-) :-D

there was a guy who kept posting on the Think Tank - got everyone's feathers all ruffled :lol: - and he talked about using a reusable syringe, about diluting the insulin (DON'T ANYBODY DO THIS) and giving incredibly tiny microdosing. don't remember his user name, but maybe it was something like owl.

people couldn't resist talking to him and they were all upset. i just read along and wondered why they bothered posting. there was a lot of "you think just because we're women we don't know anything, you're new and think cuz you're a man you know all, blah blah." very exciting reading for me. :lol:
 
Ann & Tess said:
I compensate for the lines because w/ Tess's small dose I can count out the entire dose in drops and adjust on the redraw if it is off.
Click to expand...

Ann, can you explain this to me further? Do you pull up the dose once, basically squeeze it out by drops and count (discarding first draw), and then do it again? Let me know if I'm understanding correctly.

It seems if you could measure the actual height of the insulin, ignoring the lines, it might be accurate. But then you would have to compare to a fixed size object and your eyes would be the source of error @-)
 
good point, kim. you could play with the dose til you have what you consider the "right" dose. then mark it on graph paper and compare future syringes against it for the subsequent shots at that dose.

this is critical for people with tiny doses for their cats, but i think for mooses like punkin that have a larger dose, well, i don't worry much about it. one drop amidst 7 units isn't as big of a deal for him as it is for cats getting 2 or 3 drops.
 
Kim, that's exactly what I do. I get the plunger aligned w/ the .5u line and squeeze out drops until they just start to slide off the bevel on the end. Then if it is what I usually count out (for me it is 7 drops for.5u, but what ever your count you just want to be consistent) I draw to the .5u line again and squeeze out the 2 drops for Tess's dose. Yes, I waste a dose each time and sometime more than one, I recheck if the count doesn't come out right.

We always have insulin left at the expiration date of the pen. I know some people use the pens to the end, but I usually see Tess's numbers start to creep up if I go longer. So I would be throwing it out any way.

I know others have used a slip of paper to measure the dose against, but counting drops works for us.

Julie I don't think the guy in think tank was the one I was thinking of. I think it was a couple and they were here in LL.
 
When I was dosing 0.25 and less, I noticed this all the time and thought I was going blind or crazy. I have the Relion syringes because the vet recommended Walmart and that's what Walmart gave me from her scrip. The 0 line was very close to the top on this most recent box. I thought maybe the plastic in the syringe itself might have variable thickness, or not be completely straight, and maybe they were printed accordingly. But not that I think about it, that's completely nutty and they were most likely misprints of some degree. How disturbing!

Pediatric syringes would be awesome.
 
25 unit (1/4 cc) insulin syringes are supposedly made for children but I have never been able to find them online or even a manufacturer for them confused_cat I've seen these referenced on some diabetes website but there is no mention of who makes them or where to buy. One site did mention BD but the BD web site has no info about this. Someone on the old FDMB supposedly got some from a doctor and was asked to post the manufacturer info and the markings on the syringes but never did :?

A pediatric syringe


julie & punkin said:
there was a guy who kept posting on the Think Tank - got everyone's feathers all ruffled :lol: - and he talked about using a reusable syringe, about diluting the insulin (DON'T ANYBODY DO THIS) and giving incredibly tiny microdosing.
Click to expand...

I remember reading those threads and just being :shock: :shock: :o at what the person was saying. The threads are still on Think Tank.

Ann & Tess said:
Julie I don't think the guy in think tank was the one I was thinking of. I think it was a couple and they were here in LL.
Click to expand...

Was it this? http://www.felinediabetes.com/FDMB/viewtopic.php?p=272906#p273769 and http://felinediabetes.com/FDMB/viewtopic.php?p=267830
 
Need help with ultra micro dosing for Danny! The thickness of the zero line is a huge dose difference for him. A levemir dose that is even with top of the zero line (closest to needle end) is not enough but going the tiny amount more to the middle of the zero line bounces him into 500's. Desperate because he just keeps losing weight. Senior bloodwork panel was normal except for BG. He's been to vet 3 times and they can't find anything else wrong. Is dilution impossible? Any ideas???

Thanks,
laur
 
no laur, you can't dilute the L insulins as far as i know. their formulation is part of how they work and i know for certain you can't dilute lantus. lantus works partially because of its acidic base. you can't add water without changing the ph. i am pretty sure you can't dilute lev either, although i don't recall why. perhaps someone else knows more on the topic.

what's danny's dose? does he have a spreadsheet? there are lots of lev users here that might be able to suggest something, several on very small doses.
 
julie & punkin said:
no laur, you can't dilute the L insulins as far as i know. their formulation is part of how they work and i know for certain you can't dilute lantus. lantus works partially because of its acidic base. you can't add water without changing the ph. i am pretty sure you can't dilute lev either, although i don't recall why. perhaps someone else knows more on the topic.

what's danny's dose? does he have a spreadsheet? there are lots of lev users here that might be able to suggest something, several on very small doses.
Click to expand...

His dose which is not working, is the top of the zero line (closest to the needle end). So something like .01 or .02. The middle of the zero line puts him into huge rebound (400s to 127 to 500+ in short order).

I don't have a spreadsheet up, unfortunately.

On the internet I'm seeing that some people have diluted the levemir, with a shortened shelf life resulting (I don't care about that). This page says it's done in japan: http://www.diabeticcathelp.com/COK/Japan.htm. But no one says what they used to dilute it with, or how exactly to do it. :sad:

laur
 
Status
Not open for further replies.
Back
Top