[Hammer]

I've been on Lantus now for a little while and I've been slowly increasing the dosage when my morning fasting numbers are still too high. I increase the dose by 2 units when I make an increase. When I hit 40 units, I've noticed that my injections seem to cause a small drop of blood mixed with the Lantus to pop out of the injection site when I pull the needle out. Is this normal?

I'm up to 44 units now and it seems to be happening with each injection. Is it possible that with this much Lantus that it's too much for the area it's being injected into and some of it pops back out? Should I do two smaller injections or is this occurrence normal?

[BlueSky]

You would get better absorption and more even coverage if you split that dose into two shots. Say one in the morning and one before bed. You can also try wating for a while (say 5-10 seconds) before you pull the needle out. You still sometimes get insulin leaking out, but not as much.

[ant hill]

Originally Posted by Hammer

I've been on Lantus now for a little while and I've been slowly increasing the dosage when my morning fasting numbers are still too high. I increase the dose by 2 units when I make an increase. When I hit 40 units, I've noticed that my injections seem to cause a small drop of blood mixed with the Lantus to pop out of the injection site when I pull the needle out. Is this normal?

Count to 6 slowly then take out the needle.

I'm up to 44 units now and it seems to be happening with each injection. Is it possible that with this much Lantus that it's too much for the area it's being injected into and some of it pops back out? Should I do two smaller injections or is this occurrence normal?

Allow the injection some time as it still injecting the dose.
These devices are good but the fluid is still moving due to the size of the syringe.

[Hammer]

When I'm finished pushing down on the back of the pen, the injection should be finished, so I'll count slowly from 1 to 10, then back down from 10 to 1.(they say to wait ten seconds so I figure counting slowly in both directions is at least ten seconds.)

Maybe I need to wait a little longer? I also pinch the skin together and then insert the needle. Does the pinching restrict the area that the Lantus has to settle into? Would it help to release the pinch before I pull the needle out? Considering that it's a large pinch of fat, I wouldn't think it would matter.

[owlyn]

Try injecting with more force.

[Hammer]

Originally Posted by owlyn

Try injecting with more force.

I'll try that. Thing is, the way this pen operates, when you set the dosage, you unscrew the back of the pen till you see the correct dosage in the window. When you push the back of the pen to deliver the dose, the back of the pen screws in, so no matter how hard you push, the only thing that happens is the pen will screw in faster. It will still deliver the Lantus faster, but not much. It's worth a try though.

[Razo681]

One thing I remember being told is to leave the needle in a little longer. Then count to 5 (doh just noticed that you posted the counting thing). Do you grab a peice of fat before you inject? I grabbed too hard once and it didn't turn out well I've also noticed this happens when I stab myself in a not so fatty area. Plus don't forget that the pens will automatically get a little out of the syringe if its primed well (shoot 2u first until a steady bubble of insulin is at the tip of the needle). So when you take the needle out there will very likely be insulin on the tip.

[Hammer]

Originally Posted by Razo681

Do you grab a peice of fat before you inject? I grabbed too hard once and it didn't turn out well I've also noticed this happens when I stab myself in a not so fatty area. Plus don't forget that the pens will automatically get a little out of the syringe if its primed well (shoot 2u first until a steady bubble of insulin is at the tip of the needle). So when you take the needle out there will very likely be insulin on the tip.

Since I have an abundance of fat, I always pinch a big piece of it. I called the doctor today and they couldn't figure out why this was happening. They suggested that I release the pinched fat before I remove the needle, so I'm going to try that...as well as leave the needle in a little longer.

I do know that when I prime the needle, there's a few drops of insulin on the front of the pen as I stick it in my skin, so there will be a few drops of on me when I remove the pen. It might be that what I thought was insulin mixed with a drop of blood that bubbles out, is really just a drop of blood that bubbles out and then mixes with the insulin that's on my skin.

I'll see what happens tonight.

[Alice]

I can't leave the needle in very long at all...I'm in and out fast! I bruise easily when doing the "count"...so I give it a second of two...then out. I fear if you are getting blood you are leaving it in too long.

[RobiJo]

What size pen needle are you using? I have more problems when I use the mini. Shorts work fine for humalog (usually less than 10u) , but if I'm taking Lantus/Levemir (around 50u) I use a regular lenght needle. I also split the dose and give 2 injections. I'll give half in my left arm, half in my right. I don't tend to split the dose into morning/night because if I'm off my pump it's for a short duration (<24 hours), but that may be somthing else you and your doc could consider.
Also, I've never been much of a pincher, but seem to remember from childhood that you unpinch after you insert the needle. Pinching the whole may be causing it to come back out.. path of least resistence.

[lottadata]

Where are you injecting?

I occasionally get those blood drops when I inject in certain areas that are rich in capillaries. Then I get ugly bruises. I moved my injection site to the upper top of my leg and don't see them anywhere near as much as when I was using my tummy.

Not the spots where you get the blood and try a different area until you find ones that aren't as richly supplied with capillareis close to the surfact.

[Hammer]

Okay, it's still happening. I tried releasing the pinch before removing the needle and I left it in a little longer. I guess I'll try the quick removal idea to see if that works. If that doesn't work, then I guess I may need to try two injections.

They keep giving me different needles. The shortest is 31 gauge 8mm (5/16 inch). The new ones are 29 gauge 12mm (½ inch). I had some that were 30 gauge 12mm (½ inch) I've used all three, but I haven't used the longer 12mm needles since this problem started. Maybe I'll use one of those tonight and see what happens. I can always use the shorter 8mm needles with the Byetta.

I was moving the injection sites around each night. I read that you shouldn't use the same area every day or that area could get hard.(whatever that meant). I would use one leg one night, then the other leg the second night, then one side of my abdomen the third night, and finally, the other side of my abdomen that fourth night. The fifth night I'd start the cycle again, but since I've added the Byetta, I inject my abdomen with the Byetta and my legs with the Lantus.

I usually use the upper thigh area...either the top or outer part of the thigh, since that's where I can get a bigger pinch. I also stretch my leg out to relax it, that also allows me to grab a bigger pinch.

[fgummett]

Originally Posted by Hammer

I was moving the injection sites around each night. I read that you shouldn't use the same area every day or that area could get hard.(whatever that meant).

You are doing the right thing by rotating injection sites... over time an overused area can become not only hard to the touch (and also hard to get the needle through) as a result of scarification, but it can also negatively affect the absorption of insulin and lead to inconsistent behaviour of the insulin/sugars.

I was also wondering about which needles would work best in this situation.

How red is this blood drop? Is it the same colour as when you prick your finger? As you may have already experienced, a very small drop of blood will go a very long way... try putting just a drop or two in a sink full of water

[Hammer]

Originally Posted by fgummett

.

How red is this blood drop? Is it the same colour as when you prick your finger?

No, it is a very dark red....almost a black/red. The finger prick is a bright red.

[Hammer]

Okay, so I tried using the longer (12mm) needle and not leaving the needle in as long and it worked, the blood didn't bubble out like it's been doing. I did get a little bleeding, but that sometimes happens. It's the same as if I accidentally stuck myself with the needle tip and it bled a tiny bit.(bright red blood).

I guess this is the way to go....the longer needle and removing it faster after the injection.