In the United States, kids with diabetes have traditionally taken insulin injections via syringe. Outside the US, insulin pens are much more common. In contrast to vials and syringes, insulin pens offer great convenience and greater dosing reproducability. Pens are also very easy to use, even for kids. (Parents will need to insert the insulin vial for little kids, but older kids will have no problem.)
As more kids choose to use an insulin pump or a basal-bolus multiple dosing regimen of Lantus® and either NovoLog® or Humalog®, pens become an excellent option for insulin dosing. And for kids, no pen beats the NovoPen® Junior. The NovoPen Junior is Highly Recommended.
Using the NovoPen Junior
The NovoPen Junior is a substantial instrument, with an excellent feel. The pen is constructed of aluminum and plastic and seems to be very well made. The NovoPen Junior is basically blue with either lime green or orange highlights. It comes with a soft-cloth carrying case that accommodates two NovoPen Juniors, extra PenFill® insulin cartridges, and pen needles.
The NovoPen Junior uses Novo's 3 mL PenFill® insulin cartridges. Novo recommends using NovoFine pen needles. In general, pen needles are thinner and sometimes shorter than syringe needles. Loading insulin and attaching the needle is simple enough for grade-school aged kids.
Dialing in the dosage is very easy. The minimum dose is 1 unit, but after that, you can increase the dosage by half-units up to 35 units per dose. If you dial in too much, you can reset the dose to to zero and start over. (The process takes two hands but is 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 fast ratcheting sound as the insulin is injected.
Like all pens, the NovoPen Junior should be held in place for six seconds 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.
Pen devices are limited to injecting one type of insulin at a time. If you mix insulin -- for example, NPH and Regular -- you would need one pen device for each type of insulin.
For pump users, pens make an excellent backup device, and for kids on pumps, the NovoPen Junior is ideal due to its half-unit dosing ability. If a pump has a problem, you can always use the pen to take extra insulin. Kids who use a pump will also find keeping a NovoPen Junior at school quite convenient.
For kids (or adults) who are needle-phobic, Novo makes the NovoPen PenMate, which hides the needle during the injection process. The PenMate is very easy to use.
Questions about the durability of the NovoPen Junior are addressed in a report entitled NovoPen® Junior Device for Pediatric Insulin Dosing: Accuracy & Durabilty by Olga Santiago, MD, of Novo Nordisk. In this test, 65 NovoPen Junior devices were subjected to a variety of abuse, similar to what would be experienced in real-world use. In all cases, the pens delivered accurate dosing. Parents can rest assured that a NovoPen Junior will survive the normal wear and tear that kids will dish out. You can read the two-page report:
For More Information
- Insulin Pens
- Needle-phobic pen users should check out the NovoPen PenMate
- NovoPen Junior Website
- Assessment by patients with diabetes mellitus of two insulin pen delivery systems versus a vial and syringe (Clin Ther. 1998 May-Jun;20(3):486-96)
- A comparison of insulin pen use in the United States and the United Kingdom (Diabetes Educ. 2002 Jan-Feb;28(1):52-6, 59-60)
Novo Nordisk, Inc.
100 College Road West
Princeton, NJ 08540
1-800-727-6500 Toll Free in the United States
The NovoPen Junior with the cover off, showing a NovoLog PenFill cartridge and NovoFine needle. Click for a larger image.
The NovoPen Junior being held, showing its size.
The dosing dial on the Novo Pen Junior, which can deliver insulin in half-unit increments.
The two colors of the NovoPen Junior, showing their size
September 19, 2003
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