Research Showing Greater Dosing Accuracy Using Insulin Pen For Injection

Alex1313

Alex1313

Member Since 2018
Forgive me if this has been posted previously. My search for a more accurate way to administer 1.0 units of Lantus with syringes that seem to be highly variable, and published research showing as much as well as human error resulting in variation, has led me to this article published in 2015:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6067590/

It appears that using an insulin pen to administer small doses of u-100 insulin in cats, not drawing into a syringe from a pen, but using the pen itself is more accurate and precise than using a syringe. Does anyone have experience using this method? This article states that the cats generally tolerate it well.

There IS a pen compatible with Lantus that can increase by .5 units rather than whole units, although its smallest dose is 1.0 unit.
 
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We don’t dose cats in multiples of one unit of insulin. For example, both dosing methods here make changes by 0.25 units at a time. Since pens can only dose in whole units, it means you can’t use pens most of the time. In addition, if you are using pens, the recommendation is to leave the insulin out of the fridge for the pen mechanism to work properly. Insulin kept out of the fridge has a much shorter shelf life than insulin kept in the fridge.

Yes, we have had some people use pens to start, but they generally change to syringes later to make those finer dose changes. Some people here use digital calipers to measure their dose, providing more consistent dosing.
 
I used the pen initially. The problem came in when I came here and you can't do the .25u increments. Plus, a pen can last me 3 months kept in the fridge just drawing what I need. Outside the fridge the potency is only guaranteed for 28 days outside the fridge.

Plus I found it easier to handle the syringe then the pen in my small hands. I used the insulin ruler to keep my dose consistent.
 
Wendy&Neko said:
We don’t dose cats in multiples of one unit of insulin. For example, both dosing methods here make changes by 0.25 units at a time. Since pens can only dose in whole units, it means you can’t use pens most of the time. In addition, if you are using pens, the recommendation is to leave the insulin out of the fridge for the pen mechanism to work properly. Insulin kept out of the fridge has a much shorter shelf life than insulin kept in the fridge.

Yes, we have had some people use pens to start, but they generally change to syringes later to make those finer dose changes. Some people here use digital calipers to measure their dose, providing more consistent dosing.
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The article mentions that there are some pens that dose at .5 unit increments. Of course this isn't a solution for everyone because the type of pen available may not be suitable for someone's particular situation but I still think the information is useful, if for no other reason than to see the discrepancy in doses among methods but especially if one of the pens available is of a type of insulin that someone is using.

Lantus has a compatible pen that will increase doses by .5 units, "The JuniorSTAR pen has the advantage of delivering half units, although the smallest dose it can deliver is 1 U. "
 
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Sienne and Gabby (GA) said:
The alternative option that many people use in order to be more consistent with dosing is to use digital calipers to help with accuracy. There are instructions on the Board for how to use them.
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This member previously expressed that time was of essence and they were having trouble spending the necessary time needed to measure out 1 unit by eye, so calipers would be more labor intensive and wouldn’t work for this person.

I personally also have the kind of schedule plus number of pets where i would have never been able to use a caliper. The same reason I wouldn’t follow the TR protocol. Although I was willing to do a little more than the “average” caretaker of a cat with diabetes, calipers and TR can be too much even for some motivated people.
 
Another few issues with using the pen.....you are supposed to "prime" it first, which wastes the first couple of units before you shoot.

Also, if you use the "dial a dose", you can't put the pen in the refrigerator because the cold messes with the mechanism so it's going to go bad a lot sooner
 
Actually, calipers took less time, not more, than eyeballing doses. I have done both, There is a little overhead to set a new dose on the calipers, but after that it’s really quick. And it ensured hubby and I were giving the same dose. It took something like 30-60 seconds to draw the dose. Once I knew how many millimeters were in a unit, changing the calipers to a new dose took about 10 seconds.
 
The pros and cons of using insulin pens was brought up years ago in the SYRINGE & INSULIN INFO: HANDLING, DRAWING, & FINE DOSES sticky. Those who aren't familiar with the advantages and drawbacks might want to take a look. The info is dated in that the Junior Star Pen which dispenses in increments of 0.5 units for Lantus only has not yet been mentioned by name, but the premise is the same. I'll add it when I get a chance.

When choosing pens versus syringes, please make sure you're aware of the limitations and use of a pen. It's different than when using syringes. For instance a pen must be primed... wasting 2 units every time one draws a dose or the dose will end up being less than one thinks. Also, pens are not to be refrigerated because of the pen mechanism. Anecdotal evidence has shown us we're usually able to use insulin to the last drop if we keep the insulin refrigerated.

It's a decision each of us has to make for ourselves, but speaking for myself... given the cost of insulin in the US, I sure don't want to waste 2 units every time I use the pen to administer insulin nor do I want to discard un-refrigerated Lantus after 28 days. IMHO, it's not worth the accuracy reported when drawing up to 5 units of insulin... especially when considering doses must be drawn in increments of 0.5 units only. Alex was pretty tightly regulated when she wasn't ill. I never would have been able to achieve that with her given the limitations of the pens.
 
If the calipers have the locking option you lock in place for the dose you are giving. Therefore it's always set. I personally find it faster especially for AM when I'm still half asleep.
 
I too used digital calipers. The only times it took extra time was when the dose changed but the calipers were easy to change.
 
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