What would be your ideal unit increments for your fast acting pen?

[shiftzor]

I was wondering how many people have trouble or are happy with pen increments for fast acting insulin, I personally think 0.25u would be very useful as often I can't correct as my bg would drop too low. I am aware of only:

2 units pens
1 unit pens
0.5 unit pens

[Lizzie G]

Im in full agreement with you on that one. I cant stop raving about my new 1/2 unit pen which i got last week, prior to that correction was more about waiting to the next meal as 1 unit would take me down too much; eg, if i was sitting on 8.5 and knew my novorapid was pretty much done, a unit could safely take me to around 5 but depending on the time of day and how active i was it could feasibly plummet to 3.5, not something i could be bothered with, a half unit happily takes me where i want to be. 0.25 would be even better though....

[RobiJo]

Small increments for corrections is one of the things I love the most about the bolus wizard on the MM. If I need 0.1 or 0.2 for a correction I can do it, where I couldn't on shots. For meals though a pen with 0.25 would be highly annoying for me. 1u or 2u would be fine as no meal of mine is less than 5 units. (I carry 1u pens for backup)

I could see a huge benefit for young children on insulin to have a 0.25 increment pen as many have very small amounts of insulin requirements.

[Funnygrl]

The problem with 0.25 unit increments is if you want 10 units it takes 40 clicks to get there. The max dose on the pen would need to be like 15 units.

0.5 would be ideal because you can get fine enough increments while still able to dial higher doses.

Actually, a pump is ideal ;)

[Simons70]

Hi All-
Boy, I am one of those believers in the one-half unit pen. I really like the Novolog Junior pen. The reason I left Humalog is that they quit making the half unit pen.
I find the half unit really helps me fine tune my insulin needs.
Simons

[Alice]

I waffled between the .25 and the .5 increment. I decided that half the time it's a big guestimation anyway...so half would be fine for me. If it were an exact science and our food/bodies behaved the same all day...then .25 would nail it on the head for most people. So, either one is fine for me.

[shabbie]

the pens used to frustrate me a little because of the size of the increments.
i am pretty insulin sensitive. the pump allows me much better control mainly because i can apply such small amounts.

[Gary_W]

A smaller pen would have been good on MDI; I was on a TDD of 30-35u and 1u would drop me between 2.5 and 3.3 (UK numbers) depending on the time of day. Correcting a BG of 7.5 wasn't really an option. It is those on low doses who are highly sensative to insulin that require this feature. For folks on the large doses it's obviously less of an issue.

The Animas pump I've been on for almost 48 hours does 0.05 unit increments. In other words, 1/20th units. I am officially in love with it already for that and several other reasons. I put in 4.35u for breakfast this morning :D

I agree with Funnygirl about the clicky problem, but a 0.25 u pen for the insulin sensative would be great; who amongst that group would ever whack in more that 15u of rapid in one go anyway?

Gary

[shiftzor]

The problem with 0.25 unit increments is if you want 10 units it takes 40 clicks to get there. The max dose on the pen would need to be like 15 units.

0.5 would be ideal because you can get fine enough increments while still able to dial higher doses.

Actually, a pump is ideal ;)

I have never taken 15 units in one sitting of novorapid in my life. I understand about the number of clicks which might get annoying but I currently only use 0.5-6units on my pen. 6 units would be 24clicks which isn’t too bad considering I rarely dose for 6 units and the full 15units would be about 60 clicks. 0.25/0.50/0.75/1 etc. Kids and anyone on their honey moon would definitely be a beneficiary and yes the ultimate answer is pumping but not all of us have that luxury ;).

[Emm]

I love my demi pen. Taking half a unit correction is almost totally stupid but it's all good for the final results. With the .5u pen I can make my doses much more exact, and I'm much happier with my numbers :)

I could do with a quarter unit pen sometimes too! But that's probably overkill. I wouldn't need it often but it would be handy for those lower carb meals where I may need just 1.5 or 2.5 units.

Imagine a correction of .25u... which would still take around 4 - 5 hours to do it's thing. Barely worth it. If I'm in a place where I just need a tiny correction, then I take a bigger correction and eat a cracker or something with it. At least it's faster that way (No good for the weight loss plans though!)

Either that or if I know a meal is coming within a couple of hours I'll just take a unit. It takes longer than that for it to be finished anyways.

But yes, I digress... I'd love a .25 pen, but only about once or twice a week! And I agree with the comment above - those who would find a use for a quarter unit would be those on smaller doses, so the smaller jab limit wouldn't bother them.

[UpNorth]

I'm happy with the 1 unit increments pens i have, i don't even have a .5 pen... But i guess .25 pens could be very useful for children who might need .75 units or so and that's pretty **** difficult to draw up in a syringe and impossible on a pen...

[RobiJo]

I agree with Funnygirl about the clicky problem, but a 0.25 u pen for the insulin sensative would be great; who amongst that group would ever whack in more that 15u of rapid in one go anyway?

Gary

Well lets see, say 1u/30g (which I'd consider fairly insulin sensitive) that would mean eating 450g at once. Just thinking of that much that makes me feel sick. I doubt anyone who really would need this small increment would need a 10u dose, let alone a 15u dose. I think a 0.25 pen could easily be marketed for children and prescribed for adults as well. Which is what I believe happened with the Novolog Junior pen.

[DarthDiabetes]

Just got a novolog junior pen myself and while I agree a pump is where I will go, that was not the question eh?

I voted 0.5 :)

[Funnygrl]

who amongst that group would ever whack in more that 15u of rapid in one go anyway?


You'd be surprised. I've heard of people complaining about the 25 unit max bolus on the Paradigm. I'd say 13 units at a time is my max I've ever done.

My ratio is 1:10 at dinner (ie, 150 grams for a 15 unit dose), however, 1 unit drops me by 70 so I'd appreciate fine correction ability.

[Eddy]

I agree with Funnygirl about the clicky problem, but a 0.25 u pen for the insulin sensative would be great; who amongst that group would ever whack in more that 15u of rapid in one go anyway?


Ehhhh.... the other day I ate a meal that I guesstimated at 16U (1U:15g)... and ended up needing another 7U several hours later. But I'm rarely that gluttonous. ;) That was the largest meal I'd eaten in more than a year; I usually eat 100g or less CHO per meal.


Imagine a correction of .25u... which would still take around 4 - 5 hours to do it's thing.


For me: Insulin aspart finishes in about 1hr 15min.

Feh. I need to get off my buns and try to score some diluent. I really want to whip up some U-25, U-30, or U-33. (I use syringes because I mix; dilution seems the best way for finer granularity.)

It seems that U-100 is better suited for resistant type 2 folks. For type 1 (especially pediatric!) use, one unit is just a bit much...

[Eddy]

1 unit drops me by 70

If you don't mind my asking: How much do you weigh, anyhow?!

(If you do mind my asking: I'm now in big trouble!)

[shiftzor]

1 unit drops me 5.5mmol/L (100 mg/dl) and i weigh 64kg, d*mmit those 0.5 people are winning ;). I need my 0.25u 1.3mmol/L (24.73 mg/dl) corrections :D.

[ant hill]

Would be fair to say that if you have small doses then the half and even smaller increments are needed?

I take too much insulin to benefit from having small increments like 30U Bolus is indeed large. so to have 31U would be what, Just 0.3% more. ;) Not much of a difference. :o

[Gary_W]

I'm just wondering if part of the problem is 'how do you make a pen mechanism THAT fine?'. It could purely be an issue of mechanical engineering. Pens are made to a cost, and i wonder if the nuts and bolts side of things make it prohibitively expensive? I know that a pump will do 1/20th of a unit for bolus (and finer still for basal, I believe my Animas is capable of a delivery of 0.00125 units (minimum basal of 0.025u per hour, and it delivers that split into 20 even doses i.e. 0.00125 every 3 mins). However, that costs lots and has a precision motor / feedback from the motor as to exactly where the plunger is so it's possible. I wonder how possible it it to get accurate small doses in the confines of a pen?

Gary

[Funnygrl]

If you don't mind my asking: How much do you weigh, anyhow?!

(If you do mind my asking: I'm now in big trouble!)
I weigh a lot. I'm 6 feet tall and strong and fat all in one. And we'll leave it at that.

[Eddy]

I weigh a lot. I'm 6 feet tall and strong and fat all in one. And we'll leave it at that.

Hunh. I thought insulin sensitivity was based on mass and conditioning. Evidently there's more to it than that. Or you're conditioned enough that you're twice as sensitive as someone who's just a teeny bit shorter than you. Interesting. Thanks.

[ant hill]

I weigh a lot. I'm 6 feet tall and strong and fat all in one. And we'll leave it at that.

LOL Funnygirl, You're not alone as we just make sure that we cover the insulin and DO NOT FALL LOW!!! :mad:

Now where is that cure. :T

[shiftzor]

I'm just wondering if part of the problem is 'how do you make a pen mechanism THAT fine?'. It could purely be an issue of mechanical engineering. Pens are made to a cost, and i wonder if the nuts and bolts side of things make it prohibitively expensive? I know that a pump will do 1/20th of a unit for bolus (and finer still for basal, I believe my Animas is capable of a delivery of 0.00125 units (minimum basal of 0.025u per hour, and it delivers that split into 20 even doses i.e. 0.00125 every 3 mins). However, that costs lots and has a precision motor / feedback from the motor as to exactly where the plunger is so it's possible. I wonder how possible it it to get accurate small doses in the confines of a pen?

Gary

I guess the bigger issue is that they may not make an awful lot of money out of it as the market for such a device is small I would imagine, unlike a pump which is marketable to every diabetic. I definitely think it’s a combination of all of these factors, which sucks for people like me :(.

[Lizzie G]

The problem with 0.25 unit increments is if you want 10 units it takes 40 clicks to get there. The max dose on the pen would need to be like 15 units.

0.5 would be ideal because you can get fine enough increments while still able to dial higher doses.

Actually, a pump is ideal ;)

i hear what you're saying but couldnt you just have 2 different pens and you could use whichever suits your needs best on a given occasion?

[shiftzor]

i hear what you're saying but couldnt you just have 2 different pens and you could use whichever suits your needs best on a given occasion?

I think it would be better to change the feeling of the clicks, i.e clicks of whole units are stiffer than clicks of half units and then the 0.25 units is even less stiff. This would mean that racking up whole units would be easy however it would make it fidlier to rack up those less used half or quarter units. Might work. ;)