The new B-D insulin pen uses 1.5 ml insulin cartridges (150 units) from Novo Nordisk or Eli Lilly. It can deliver from one to 30 units of insulin with one unit granularity, making suitable for use by children with diabetes. You cannot select a half unit, however.
The B-D Pen is simple to use. The unit unscrews easily to insert the insulin cartridge. The insulin dosage is selected by turning the dial end of the unit. The dosage ranges from one to 30 units. Even units from zero to 30 are marked, with odd units indicated by a line. Each time one unit is dialed in, you hear and feel a "click." If you accidentally dial in too many units, you can easily reset the dosage by dialing beyond 30 units, at which point the reset groove appears. Simply pressing in the end of the pen resets the dosage to zero.
Injecting is as simple as inserting the needle and pressing down on the end. The B-D Pen injection feel is lighter and smoother than the NovoPen 1.5, which might make it easier for kids to use. Unlike the NovoPen 1.5, however, the B-D Pen gives visual no indication of the approximate amount of insulin remaining in the cartrdige.
B-D makes two needles for the B-D Pen: the Ultra-Fine (29 gauge, 1/2 inch) and the Ultra-Fine II (30 gauge, 5/16 inch). These are identical in gauge and length to the equivalent B-D syringes. The B-D Pen comes with a nice case that holds the pen, three needles and two insulin cartridges.
Use a New Needle Everytime
B-D stresses that you should never carry a pen with a pen needle attached because:
- Air in insulin cartidges can cause inaccurate dosages.
Going from warm to cool temperatures causes the insulin in the cartridge to contract, bringing air into the cartridge. This can cause dosage accuracy to be reduced by as much as 12 out of 20 units, or 60%1.
- Leakage can change insulin concentration.
Going from cool to warm temperatures can cause insulin expansion and leakage. With NPH or mixed insulins (70/30 or 50/50), fluid leakage can change the concentration of the insulin.
However, our Medical Director and Diabetes Nurse Specialist point out that most patients can reuse pen needles without difficulty. If pen needles are reused, they advise that an "air shot" of 2 units be performed before each injection. This will assure that the insulin hasn't crystallized in the needle and that the pen is working properly.
Loading insulin and attaching the needle is simple enough for grade-school aged kids. Dialing the dosage is also very easy. Reducing the dosage is also easy. Injecting couldn't be easier. Simply grasp the pen firmly in your hand, thumb on the end. Insert the needle and push down on the release button on the end with your thumb. It is your pressing that injects the insulin. You'll hear a soft ratcheting sound as the insulin is injected.
The B-D Pen should be held in place for an extra second or two after you've pushed the release button all the way down, to ensure that all the insulin has been injected. Repeated tests with one unit of insulin showed that one unit consisted of three small drops of insulin. The third drop continued to form for several seconds after the release button was fully depressed. For kids who take one or two units of insulin at a time, you'll want to be sure that every bit of insulin is injected before removing the needle.
Children with diabetes often mix a short acting (e.g., Regular or Humalog) and long acting (e.g., NPH or Ultralente) insulin in the same injection. This is not possible with the pen injectors. Kids who decide to use the B-D Pen for all their injections should get two pens, using one for their short acting insulin and one for their long acting (or use the pen for the Regular or Humalog, and a standard syringe for the NPH or Ultralente). Since the Ultra-Fine II needles are so small, most kids won't mind the extra injection.
Insulin types available for the B-D Pen include Humalog, Regular from both Novo Nordisk and Eli Lilly, NPH, and 70/30 mixes. Ultralente is not available, according to the Diabetes Team.
Many kids are adopting a three-shot-a-day regimen of UltraLente for basal insulin and pre-meal Humalog or Regular to cover carbohydrates. For kids using this regimen, using a pen at school for the pre-lunch injection is highly recommended. The B-D Pen is simpler to use than a needle and insulin vial.
BD Consumer Healthcare
1 Becton Drive
Franklin Lakes, NJ 07417
The reviews of products are the opinion of children with DIABETES. Each product is reviewed with a single purpose: to determine if the product is suitable for use by children with type 1 diabetes, their parents, and, to a lesser degree, adults with type 1 diabetes. There are many products aimed at adults with type 2 diabetes that are not appropriate or suitable for children or adults with type 1 diabetes.
Review updated July 7, 2001
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