Insulin Pens

Contents

• What Are Insulin Pens?
• Advantages Of Insulin Pens Over Traditional Syringes
• Prefilled Pens
• Reusable Pens
• Children’s Insulin Pens
• Pens And Older People
• How Insulin Pens Work
• Pen Safety And Care

More Related Guides

Diabetes Guide
Guide to buying glucose monitors

What Are Insulin Pens?

Scientists are always looking for new ways to improve on the standards of diabetes treatment. For example, they are continually trying to create better delivery devices for self-administering insulin. The insulin pen is one such device. Insulin cannot be taken in pill form, it has to be injected. Traditionally this required patients to use the vial and syringe method but this is no longer necessary. While the insulin pen does not eliminate the need for a needle, it does have a shorter needle so it looks less scary. The pen also has the added benefit of controlling insulin dosages better. This is important because studies show that as many as 80 percent of patients who self-administer with a syringe alone, administer the incorrect dosage. Now insulin pens offer a more flexible, convenient and safer alternative. Pens either come with an insulin cartridge already inserted (and the pen is discarded once the cartridge is spent) or they are reusable and the cartridge is replaced when it runs out (like an ink cartridge would be). The technique for insulin delivery is similar for both devices. Once a needle has been used it must be disposed and another one screwed on for the next injection.

Advantages Of Insulin Pens Over Traditional Syringes

1. They are discreet which makes them more socially acceptable to use in public (this is particularly important for kids). Traditional syringes have a stereotypical association with illicit drug users.
2. They offer more accurate dosages.
3. They are less painful because smaller needles are used.
4. Simpler for older adults, children and pregnant women to use.
5. More flexibility because they offer disposable or reusable options.

Insulin pens are hugely popular throughout Europe, with an estimated 70 to 90 percent of all insulin being delivered by pen. However, in the United States the figure is only 2 percent. This may be because of problems getting a reimbursement from insurance companies or lack of knowledge on the part of patients and doctors about pens.

So should you shift from a syringe to a pen? If you're comfortable with the vial and syringe method and you feel your technique is accurate, you may not have a big enough reason to do so - particularly as insulin pens are more expensive than syringe insulin therapy. It should also be noted that people who take NPH insulin at bedtime and regular or lispro insulin before meals usually need to use two pens - one for each type of insulin. Also patients who currently take a mixture of two kinds of insulin in one injection, would need to use two pens - so this can make switching from a single-syringe injection to pens less desirable. However, if you are new to insulin delivery, or have bad eyesight or have difficulties in administering accurate amounts of insulin, a pen is probably the best option for you.

Prefilled Pens

These pens come preloaded with insulin and are designed for single use. As the device doesn't require loading it is especially convenient. They are useful for people who have difficulties handling cartridges in reusable pens, or those who wouldn't always have time to stop and change cartridges. As with anything extra convenience, it comes with a price. Prefilled pens usually work out slightly more expensive than reusable pens over time. In the U.S. Novolin 70/30 was the first prefilled pen on the market (launched in 1993), but Eli Lilly has subsequently introduced other reusable pens under the brand names Humulin and Humalog. These pens make a clicking sound so that the visually impaired can hear the number of units when dialing a dose and they have a large magnifying window that displays the number of units. All pens are used in conjunction with glucose monitors for blood glucose monitoring.

Reusable Pens

With these pens the patient inserts an insulin cartridge into the pen's chamber. This may be useful if the patient needs to change their insulin prescription because it means they won't have to buy a new pen. Reusable pens tend to be slightly more economical than prefilled pens. On the downside, pens can become less sterile over time raising the risk of infections and even though the designs are usually hardy, the pens can become damaged with constant use. Reusable pens on the U.S. market currently include: Autopen AN 3000 and AN 3100 by the manufacturer Owen Mumford, Novo-Pen 1.5 and NovoPen 3.0 by Novo Nordisk, B-D Pen Classic and B-D Pen Mini by Becton Dickinson, and Humalog and Humulin pens by Eli Lilly.

Children’s Insulin Pens

Kids prefer using insulin pens for many reasons. One being they are particularly aware of their peer’s reactions to syringe injections and the connection to illicit drug use. In some schools the vial and syringe method of injecting insulin is relegated to the principal's office, which carries a stigma of its own. In comparison insulin pens do not require refrigeration so they can be carried in the child's backpack and used in the classroom without the child ever having to leave their desk. Some insulin pens are designed specifically for children and come in colorful funky colors (NovoPen Junior for example).

Pens And Older People

The majority of patients over 60 who are taking insulin have some type of physical disability. Insulin injections with the traditional vial and syringe method have a high rate of error in this age category. People with sight impairments for example may not notice air bubbles in the syringe, and this can compromise the delivery of insulin. Insulin pens can help improve the accuracy of dosing in older people and those with tremors will find the procedure much easier to perform.

How Insulin Pens Work

The following information applies to both prefilled and reusable pens:

1. A disposable needle is screwed onto the pen and the pen is primed.
2. The patient dials the appropriate dose which can be viewed on the display window of the pen. Most pens make a clicking sound as the dial increases.
3. The needle is inserted into the skin and the plunger button is clicked. This delivers the dose.
4. One slight disadvantage is that the pen needs to remain in the skin for about 5 seconds after the plunger is depressed (this is longer than with a traditional syringe injection).
5. Insulin cartridges for reusable pens can be bought in 1.5 or 3 ml volumes and are specific to the pen size.
6. Cartridges should be stored in a refrigerator before use, but once the cartridge is placed in the pen, the pen can be kept at room temperature (less than 86°F) for as long as a month. It just needs to be kept away from direct heat and light.
7. The disposable needles attached to insulin pens have some advantages over standard syringes. They are shorter, so are less painful. Also, as the pen’s needle doesn't have to puncture a vial to collect insulin, the needle maintains its sharpness, further reducing pain.

Pen Safety And Care

Insulin pens are designed for use by one person - they should never be shared, even if the needle is changed. The Centers for Disease Control and Prevention (CDC) recently issued a warning to all healthcare providers because they have become increasingly aware of reports of improper use of pens. Sharing pens can place patients at risk of infections such as hepatitis and HIV. Regurgitation of blood into the insulin cartridge can occur after an injection which exposes patients to infection if the pen is used for more than one person, even when the needle is changed. Hospitals and health workers need to be aware of this. In 2011 one incident which involved diabetics being exposed to shared pens resulted in 2,000 people being contacted.

Related Articles on Insulin Pens

For more on diabetes, see the following:

• Understanding the causes of diabetes.
• How does a doctor give a diabetes diagnosis?
• Can you recognize the symptoms of diabetes?
• Check out our recommended diabetes resources.
• Top 10 diabetes tests you need to prevent diabetes complications.

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