injecting air into vial?

[Charliemeow]

Hi all! I switched to lev in march from pz. With pz you are supposed to inject an equal amount of air into the vial to the amount of insulin you are going to draw out of the vial. I was under the impression that this was a big no-no with levemir. but I've had a few issues this week with "springy" syringes-- When I try to draw up the dose from the vial, it keeps shooting back into the vial. A bean in my acro group said that the vaccuum in the vial is the reason for this, and that I should inject air before drawing up my dose. Do any of you use vials? What should I be doing?? confused_cat

 

[Melissa and Celle]

I had also heard that you aren't supposed to inject air into the vial or pull up too much insulin and push it back into the vial because air bubbles are bad for Levemir. However, the instructions that came with the Levemir vial say to do both of those things. Perhaps because they want everyone to replace their vial after 28 days?? Even if not ideal, it seems like it can't be so bad if they actually recommend doing that, particularly if you need to do that to get an accurate dose.

However, I don't ever inject air into the vial to get rid of the vaccum because it has never been necessary to get a nice clean dose with no air bubbles with the syringes that I use. I really can't recommend them enough: http://www.americandiabeteswholesale.co ... SiteSearch. I seem to remember you preferred not to shop on-line, but these just might convert you!

 

[Vicky & Gandalf (GA) & Murrlin]

The confusion comes from the fact that vials and the flexpens should be treated differently.

I believe it is standard with a vial to inject the amount of air in to the vial equal to the amount of insulin you'll be removing each time. Although I've also read it doesn't matter.
If you are getting a push back on the syringe from the vial then you probably do need to inject air. Lev is stable enough that it shouldn't harm it but there could be the possibility of affecting its stability over time since there's so much insulin in there. 1000U at 2U per day could theoretically last almost a year and a half!

The flexpens don't need air injected when drawing because they have a little plunger that comes down from the top of the cartridge as you remove insulin and it keeps the vacuum constant. At least that's how I understand it.

Good question! Thanks for bringing this up.

 

[Sheila & Beau GA & Jeddie GA]

I use cartridges and do not inject air, but over time some gets in there any way. I have actually inverted the cart (opposite of drawing the dose) and inserted a clean syringe to draw off some of that air.

One thing that I find helps with the cart, and might with the vial is to draw the plunger down and wait. It will fill with insulin after a second or two. Then I twist the plunger to push the extra back into the cart. I have always done this with lev and not had a problem with stability over time. Also, before I stick the needle into the stopper top, I pull down on the plunger and push it back to zero and hold it firmly at zero as I stick it into the cart. This helps a bit with bubbles. Might not be useful with a vial if you are supposed to inject air into it.

 

[Charliemeow]

Thanks everyone!!
Perhaps I could have thought to check the instructions with my vial. ohmygod_smile This is my 4th vial and I've never had this issue before, so I just assumed it was a syringe problem, not a "me doing it wrong" problem

However, I don't ever inject air into the vial to get rid of the vaccum because it has never been necessary to get a nice clean dose with no air bubbles with the syringes that I use. I really can't recommend them enough: http://www.americandiabeteswholesale.co ... SiteSearch. I seem to remember you preferred not to shop on-line, but these just might convert you!

I love to shop online. But I'm such a total procrastinator that I never realize I'm out of testing and shooting supplies until there's not enough time to order them! I have tons of syringes right now, so now is a great time to buy more online. I'll check those out, thank you!!