Bubbles in Insulin

Status
Not open for further replies.
Mike and Bj

Mike and Bj

Member Since 2012
I'm having trouble with getting teensy tiny bubbles in my syringe. I flick them to get them to rise and shoot insulin out and most of the time there's still a miniscule bubble or two in the liquid. I'm drawing extra insulin so I can shoot out more to get the bubbles out but nothing seems to be working. I've tried not pushing air into the bottle before drawing and and that doesn't seem to matter. I'm going through two or 3 syringes/insulin per shot so there's a lot of waste and headache as well.
 
I'm having the same problem. I've tried Relion and Walgreens. Both are the same. Thinking of ordering on-line. Terumos from ADW?
 
We have used the BDs and UltiCare Vet RX and both drive us nutz with bubbles. Anyone have good luck with a certain brand?
 
I've got the ReliOn brand. It's my first time using syringes so I don't have anything to compare them to. I'm a newb so I was thinking it could be my technique or something.
 
Actually I've used BD with Lantus and had no air bubble problems at all. BD doesn't work with Levemir, though. Way too many sticky air bubbles.

Try this: move the plunger up and down the syringe barrel a few times. Then push the plunger down to the zero line. Stick needle into pen/bottle as usual and slowly pull the plunger to just a little past the amount you need. Hold the plunger in position for a few seconds to allow the syringe barrel to fully fill with insuin. Remove insulin syringe from pen/bottle and hold with the needle pointing up. Gently tap to float bubbles upwards. Slowly push plunger up to remove the air bubles and excess insulin.
 
This was one person's spin on how to deal with bubbles:
For each shot, we do these things:

  • Throw away the plunger cap and move the plunger a couple of times. (Jojo told us that spreads the plunger lubricant)
  • Make sure the plunger is all the way to the needle end, uncap the needle, and insert the needle into the insulin cartridge.
  • Pull the plunger back pretty far, maybe the 4 or 5 IU mark. The vacuum inside the cartridge "fights" this; it goes slowly.
  • The insulin will start moving into the cylinder very slowly, watch to see how much is in the syringe.
  • When there is about .5 IU more insulin than needed, withdraw the needle from the cartridge without moving the plunger.
  • This causes the insulin to move down to the plunger (away from the needle), and the air goes up to the needle end.
  • Put the cartridge back in the fridge; do the rest of this over the sink.
  • Press the plunger to expel the excess air at the top. (don't skip this step, even if there are bubbles! The less air is in the syringe when you flick on it, the easier it is to form a single bubble that can be pressed out.)
  • If there are any bubbles at this point (often there are not), flick the syringe to bring them to the needle end.
  • Twist the syringe while pressing the plunger slowly to expel any remaining air, and to "dial in" the desired dose. This way, you can see if the bubble is sticking to the side, because you're rotating the syringe and looking at it from all sides.
  • If there's a bubble stuck to the side of the needle collar, draw a tiny bit more air in to join it, and then rotate the syringe the opposite direction to last time, while pressing the plunger. This spins the bubble together and hopefully centers it on the needle hole so you can squeeze it out.
  • Because we do micro-dose, when dialing in doses, we try to hold the syringe so the angle on the needle is facing up. This way, the little drop of insulin that forms there can be pulled back into the needle without bringing air, if we accidentally dial the plunger in a drop too far.
Click to expand...
 
Hmm, well I'm not quite using that procedure but I've had pretty good improvement now that I'm pushing hard on the plunger and keeping it tight before sticking it in the vial. I'm thinking some tiny bit of air was still in the syringe before drawing the insulin.
 
I've used Relions, BDs, Walgreens, Monojects, and now Terumos. The ones I found did best for no bubbles if you drew it right were the Monojects. Unfortunately, they have had some real problems with inaccuracies in the syringe resulting in dosing variability due to the hub. (note....all of the syringes are inaccurate because the companies are allowed ridiculous variation since a little extra or less insulin in a human doesn't affect them the way it will affect a cat). I like the way the Terumos draw but I do get bubbles although usually only one small one on top of the plunger. I"m still working on methodology for going bubbleless. The technique Sienne posted doesn't work with levemir.
 
I haven't stopped by and said Welcome to you!!

You're using a pen cartridge instead of a vial...right? Those wonderful instructions above apply to the pens.

HUGS!
 
squeem3 said:
Hold the plunger in position for a few seconds to allow the syringe barrel to fully fill with insuin.
Click to expand...
Hmm, I've always been doing exactly like you said except for this part. My last two pulls were pretty good but I'll definately add that step in the AM.

Squeaky and KT said:
I haven't stopped by and said Welcome to you!!
You're using a pen cartridge instead of a vial...right? Those wonderful instructions above apply to the pens.
HUGS!
Click to expand...
Hi, Squeaky. Thank you for the welcome :-D

Nope, I'm using a vial. But I do want to find out about these pen cartridges you mention.
 
My method works for both bottles and pens.

Mike and Bj said:
Nope, I'm using a vial. But I do want to find out about these pen cartridges you mention.
Click to expand...

In the US only the Lantus SoloStar pens are available as well as the 10 ml bottle. Other countries have the SoloStar pens and the OtptiClick pen cartridges as well as the 10 ml bottle.

SoloStar pen:
Lantus%20Solostar%20pre-filled%20pen_46237.gif


To use a SoloStar pen for a cat, you stick the insulin syringe needle into the rubber stopper at the uncapped end. There are picutres here of how to do that: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=151 and:

How%20to%20use%20an%20%20insulin%20pen%20for%20cats2.jpg


By using insulin syringes, you can measure teeny amounts of insulin. The pen only doses in whole unit increments (using pen needles) which is fine for a Human diabetic but not so much so for a diabetic cat.

The SoloStar pens are 3ml each and come in a box of five. Some people have been able to buy a single SoloStar pen at the pharmacy. Your prescription has to specify the SoloStar pens. If the pharmacist insists on selling you pen needles, don't buy them because you won't be needing them at all. Pharmacists don't know about using the pens with insulin syringes for a cat.
 
Squeem, what does a Solo Star pen cost? The 10ml vial is a whopping $135 here. My furball is making me bankrupt. Seriously.
 
I paid $190 for 5 3ml pens at Wal-Mart here in Ontario. And from what I've seen, that's expensive compared to what others pay online at Canadian pharmacies, but I needed mine ASAP.
 
Here in PA, about an hour from Philadelphia, best price I could find on 5 solostar pens was $248.00. So $190 sounds awesome!
 
Expect to pay around $200 - $250 for the box of SoloStar pens. There is a webs ite that you can use to get approximate prices at your local pharmacy. The info is posted here: http://felinediabetes.com/FDMB/viewtopic.php?f=4&t=75339

There is a coupon for $25 off your first box of SoloStar pens here: http://felinediabetes.com/FDMB/viewtopic.php?f=15&t=36964

To save some money, you can use a free prescription drug card. There are several out there. Here is one for pets: http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=53397

Some people order their Lantus from online Candian pharmacies. This thread has more info: http://felinediabetes.com/FDMB/viewtopic.php?f=15&t=11530
 
Hi Mike and BJ and welcome to LL.
I buy my insulin online from Canada Drugs Online, a reputable Canadian online pharmacy (there are many "rogue" online pharmacies, so you have to be careful; only buy from one that has the Pharmacy Checker valid seal). Prices are good ($128 plus $10 shipping for a box of 5 Solostar pens) and I have never had a problem with them. Here's a link to the Lantus page on their website:
http://www.canadadrugsonline.com/DrugMoreInfo5636.aspx
You need to register with them and then get your vet's prescription, which can be faxed from the vet's office. Make sure that the pens are specified. They are more economical than the vial.

Good luck with the bubbles. My technique is to work the plunger back and forth a few times, then push it all the way in and forcefully hold it there while you stick the needle into the insulin vial/pen/cartridge. Then, release your forceful hold on the plunger and slowly draw about a unit more than you need. Flick any bubbles to the top and twist the plunger until you get to your dose. Any bubbles should be expelled during the twisting. But some syringes are just impossible.

Welcome again!

Ella & Rusty
 
I used the Relions, and I think they were the best about not getting bubbles. For me, the key trick is to first flick the bubble up to the top and THEN draw more air IN to make a bigger bubble. Not a huge bubble, but a bubble that fills the whole circumference of the barrel. Then the bubble will express cleanly instead of sticking to the side. If you have BD or Monoject. . .beats me. I was pulling my hair out with those!!
 
Status
Not open for further replies.
Back
Top