Insulin therapy is the only treatment for people with type 1 diabetes and insulin-dependent type 2 diabetes. Unfortunately, insulin does not come in the form of tablets or pills; the only way to administer it is by subcutaneous injection .
There are several insulin delivery devices on the market, and new ones are being developed as we write. There are three ways to take insulin today: injection pens, syringes, and insulin pumps . Insulin pens are the most commonly prescribed.
But using an insulin pen for the first time can be daunting , and even though your doctor or diabetes educator has shown you how to do it, you may still be hesitant to do it yourself. This is completely normal.
So here's a detailed guide about insulin pens. What are they? How to use them correctly? How to avoid painful insulin injections? Are they better than syringes or pumps?
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What are insulin pens?
An insulin pen is an insulin delivery device preloaded with insulin that facilitates subcutaneous injection. Novo Nordisk launched the first insulin pen in 1985, a significant improvement in insulin therapy , blood sugar management and patient quality of life.
While there are different types of insulin pens, they all have the same basic parts, including:
- An insulin storage device made of transparent plastic.
- A dose knob that allows you to set the number of insulin units to inject.
- A window that displays the number of insulin units selected.
- An injection button to press down for the injection.
- A rubber seal for connecting the needle
- to the pen.
- A pen cap that protects the insulin from light and environmental conditions when it is not in use.
- Disposable needles for each insulin injection (not included).
Insulin pens can be filled with bolus, basal or premixed insulin .
Reusable insulin pens vs. disposable pens
There are two main types of insulin pens: reusable and disposable . A disposable insulin pen comes with a pre-filled insulin cartridge and is completely disposed of after use. In contrast, reusable insulin pens work with replaceable insulin cartridges that are loaded into the pen.
smart pens
Smart insulin pens (or smartpens) are relatively new insulin delivery devices. They are like simple insulin pens, but have additional innovative technology. For example , they use Bluetooth technology to send dose information to a smartphone app . Most diabetes device manufacturers now offer smart insulin pens, including Medtronic andNovo Nordisk .
Smart pens are helpful in calculating and tracking insulin doses, sending reminders, and ultimately optimizing blood sugar control . They can also help in giving more accurate half doses of insulin, avoiding missed injections, keeping track of insulin expiration dates and storage conditions, etc.
FlexPen, KwikPen and Solostar
There are currently 4 main brands of disposable insulin pens in the US: FlexPen, FlexTouch, KwikPen and Solostar. Although they are all very similar, they differ in specifics such as size, ergonomics, injection force and precision of the unit.
FlexPen and FlexTouch insulin pens are used by Novo Nordisk and are available for the following insulins: Fiasp, Levemir, Novolog, Tresiba U-100, and Tresiba U-200 .
The KwikPen is manufactured by Eli Lilly Diabetes and is used for the insulins Humalog, Basaglar and Humulin .
The Solostar insulin pen is from Sanofi and delivers the insulins Lantus, Admelog, Apidra and Toujeo .
Reusable insulin pens include NovoPen (Novolog insulin), AutoPen (Humalog insulin), HumaPen (Humalog insulin), and others.
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How much insulin is in an insulin pen?
Most disposable insulin pens and cartridges for reusable pens contain 3 mL of insulin.
How many doses of insulin are contained in a pen also depends on the insulin concentration. For example, most insulins are U-100 (100 units of insulin per mL of solution), which means that most insulin pens contain 300 units of insulin . However, if you use U-300 insulin (300 units per mL), a 3 mL pen will contain 900 units.
How to choose insulin pen needles?
Whether disposable or reusable, insulin pens work with disposable needles. You must use one needle per injection , which works out to about 365 needles per year if you inject insulin once a day, 730 if you inject twice a day, and 1460 if you inject four times a day!
Most insulin pen needles will fit most insulin injection pens . However, there are two things to consider when choosing insulin pen needles:
- The needle length . Disposable needles for insulin pens have a length of 4 mm to 12 mm.
- The needle diameter or "gauge ." Disposable insulin pen needles range in diameter from 29 to 32 gauge.
Both the thickness and length of the needle contribute to the pain experienced when injecting insulin with a pen. The shorter and thinner the needle, the less pain it will feel . However, some diabetics need long, thick needles. Price is also a factor to consider when purchasing insulin needles.
Ultimately, your doctor and pharmacist will advise you on which needles are best for you.
How to use an insulin pen?
Although insulin therapy may seem daunting at first, using an insulin pen is easy once you know the steps. And since you'll need to use it so often (at least once and sometimes up to 8 times a day), you'll be an insulin pen expert in no time!
It is important to develop good habits from the beginning and learning how to use an insulin pen correctly can help you avoid painful injections, skin problems, possible infections and, most importantly, dosing errors.
Here are step-by-step instructions for taking insulin with an injection pen:
Step 1: Check your blood sugar
Check your blood sugar with the blood glucose meter before each insulin injection , especially with fast-acting insulins before a meal. This allows:
- Adjust the dose of bolus insulin depending on your blood sugar before the meal.
- Make sure your blood sugar level is not too low before injecting insulin.
- Keep a log of your blood sugar and insulin doses so your healthcare provider can help you analyze, adjust, and optimize insulin therapy.
Step 2: Prepare supplies and wash hands
Using an insulin pen for the first time can be daunting for some patients. A good way to get through it with confidence is to prepare all of your supplies beforehand . Place the following diabetes supplies on a dry and clean surface:
- insulin pen
- pin needles
- alcohol wipes
- container for sharp objects
Then wash and dry your hand before performing the following steps and proceeding with the injection.
Step 3: Charge, check and prepare the pen
If you are using a reusable pen, insert the insulin cartridge into the pen first. With a disposable pen, you do not need to do this as the insulin is already inside.
Before using your insulin pen, always check the expiration date . Remember that insulin has two expiration dates: the one printed on the pen and the one that occurs approximately one month after it is first used or taken out of the refrigerator.
Then remove the pen cap and examine the insulin inside . Most insulin is a clear, water-like liquid. If clear insulin looks cloudy or has clumps in it, that's a sign it's spoiled, so don't use it.
However , NPH insulins or premixed insulins are usually cloudy . You need to mix these insulin suspensions before using your injection pen. Gently roll the pen between your palms and then move it up and down (without shaking it to avoid bubbles). Cloudy insulin is ready when it looks milky white.
Note: If your insulin pen was refrigerated, let it sit for a few minutes until the insulin comes to room temperature. You can still inject cold insulin, but it is generally more painful.
Step 4: Connect the needle to the insulin pen
After you've made sure the insulin in your pen is safe and ready to use, you'll need to connect the needle to the pen. Use a new needle for each injection. Start by wiping the rubber seal with an alcohol swab .
Insulin pen needles come with a protective paper tab, an outer needle cap, an inner needle cap and the needle inside . Here's how to attach the needle to your pen:
- First, remove the paper tab from the needle.
- Screw the needle onto the rubber seal of the pen.
- Remove the outer cap (save for later use).
- Remove the inner cap (you can throw this away)
Step 5: Prepare the insulin pen
You need to prime your insulin pen before each injection. Priming helps remove air bubbles and ensures the needle is not clogged . Here's how to prime the pen.
- Select 2 units of insulin using the dose button.
- Hold the pen so that the needle points up.
- Tap the pen lightly to push air bubbles to the top.
- Then press the injection button all the way in to inject the insulin into the air.
- You should see at least a few drops of insulin coming out of the needle. If not, repeat the process until a drop comes out and there are no more air bubbles in the pen.
Step 6: Choose your insulin dose
Then select the insulin dose that has been prescribed for you. Look at the dose window and make sure your pen is set to zero. Then turn the dose knob until the arrow points to the number of insulin units you want to inject. Always make sure the dose is correct before injecting.
Note: When an insulin pen is empty or almost empty, the dose knob will not turn. If this happens, throw away the pen or cartridge and get a new one to inject your full insulin dose. Do not try to split the dose into 2 injections.
Step 7: Selecting and cleaning the injection site
Insulin pens can be injected subcutaneously into the abdomen, arms, thighs and buttocks . The preferred injection site is the abdomen because insulin is absorbed more quickly there. Injection into the upper arm is slightly slower, and injection into the thighs and buttocks is even slower.
Each time you inject insulin with a pen or syringe, you must rotate the injection site and change the location. Using the same site each time can cause skin problems and affect insulin absorption.
Before injecting insulin with a pen, gently clean the skin at the chosen injection site with an alcohol swab .
Step 8: Inject the insulin with the pen
Now that everything is ready, learn how to inject your insulin dose with an insulin pen :
- Hold the insulin pen with the hand you use to write, leaving your thumb free to press the injection button.
- Use your other hand to gently press on your skin.
- Then, in one quick motion, insert the entire needle into the skin at a 90-degree angle.
- Press the injection button all the way in and hold the pen for another 10 seconds until the full dose is administered.
- Check that the number in the dose window returns to zero.
- Pull the needle straight out of your skin.
Note: Sometimes bleeding may occur at the injection site. Apply light pressure with your finger.
Step 9: After the insulin pen injection
Once you have removed your insulin pen from your skin, replace the outer needle cap on the needle, unscrew the needle, and dispose of it in a sharps container .
Replace the cap on the insulin pen. This protects your insulin from light and environmental influences. Store your insulin properly until your next injection .
insulin pen storage
Insulin is a perishable and temperature-sensitive medicine that requires special storage conditions. For safe use and optimal effectiveness, you should store your insulin pen as follows:
- Before opening , store your disposable insulin pens or replaceable insulin cartridges refrigerated at a temperature between 2°C and 8°C until the expiry date stated on the pen.
- Once opened or stored outside the refrigerator for more than a few hours, insulin pens will last for about a month at room temperature (below 25 °C).
Different insulins may have different shelf lives. Always check the storage instructions on your insulin pen packaging. For more detailed information on storing insulin pens, see the following article:
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Browse our catalog of insulin cooling and transport solutions and do not hesitate to ask us for advice and assistance.
Advantages and Disadvantages of Insulin Pens
Insulin devices and technologies are changing rapidly, and while most insulin-dependent diabetics still use traditional insulin pens or vials and syringes, there are a growing number of new options . So let's compare insulin pens with their older alternatives (vials and syringes) and their newer ones (insulin pumps).
insulin pen or insulin syringe
Insulin pens are more convenient to use than insulin vials and syringes. They are small, portable, simple and discreet to use .
Syringes are a little more complicated to use. Unlike insulin pens, you have to draw the insulin from a vial into the syringe. There is also a greater risk of breakage, as the small glass vials are very fragile and shatter easily if dropped on a hard floor.
Insulin pens are a more convenient and accurate solution for insulin administration than syringes. On the other hand, they are also more expensive.
Insulin pens or insulin pumps
Insulin pens and insulin pumps are both convenient and efficient methods of delivering insulin to diabetics. Surprisingly, although insulin pumps are new high-tech medical devices, they are not always the best solution. There are several factors to consider when deciding between insulin pens and insulin pumps .
Advantages of insulin pumps over insulin pens:
- No more injections.
- Insulin pumps offer more flexibility in insulin delivery than pens.
- More precise insulin dosing.
- Lower risk of missing an insulin dose.
- Most people find pumps more convenient than pens.
- Better blood sugar control.
Advantages of insulin pens over insulin pumps:
- No device attached to your body 24/7
- Pens are easier to use. They do not require complex programming and manipulation.
- No risk of technical problems and failures in insulin delivery.
- You need to carry fewer supplies with pens. Insulin pumps require spare supplies and infusion sets.
- Fewer skin problems with pens than with pumps.
- Pens are cheaper than pumps.
Ultimately, the most important thing is that you feel comfortable with your insulin therapy device and find the right balance between your diabetes treatment and your lifestyle.
