From Georgia, USA:
My 3.5 year old nephew takes 0.5 unit per injection. The problem is with the dead space in the syringe, making it extremely difficult to get exactly 0.5 unit at a time. Is there anyway to minimize the sampling error when filling the syringe? Can I dilute the Insulin preparation or are there very diluted Insulin preparations?
If your nephew is using insulin syringes, then the dead space is accounted for by where the markings are on the syringe. You are right that the error of an air bubble or mistake in drawing up the small dose can be significant. Just do the best you can. I usually have all people who draw up insulin for the child "standardize" what they mean by 1/2 unit, to decrease the person to person difference. Also if the same person draws up a particular dose of the day it may decrease the error.
Insulin can be diluted, however I don't dilute the cloudy insulin as the timing and peaks change when they are diluted. Regular and Humalog can be diluted using the diluent available from Lilly. Don't dilute in saline for home use. Be careful about mistakes when using diluted insulin. Commonly the insulin would be diluted to U-10 (10 units per ml) or U-50 (50 units per ml). Don't call these "units" once you dilute the insulin, but rather "lines." Make sure that if you go to an emergency room or hospital that the clinicians know that the insulin is diluted. Diluting the insulin lets you draw up very small doses of insulin, and because the volume may be bigger, less error from air bubbles or small differences in technique.
Original posting 5 Jan 1999
Posted to Blood Tests and Insulin Injections
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