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Question:

From Woodinville, Washington, USA:

I have typeá2 diabetes and, since my twice daily insulin doses exceed 100 units (typical combined doses run around 125 to 165 units), this has meant taking two shots, morning and night. About a year ago, I located a 2 cc BD insulin syringe, and I have been using them successfully. However, when I recently tried to refill my prescription again, my pharmacy said they were discontinued. I contacted BD customer service, but they have been no help in suggesting a replacement. Do you know of anyone else who makes a 2cc insulin syringe? Preferably with a short, somewhat fine gauge needle? I do not like taking double shots twice per day.

Answer:

Rather than taking two shots twice a day, I would suggest that you talk to your diabetes doctor about using Lantus (insulin glargine) at bedtime for basal insulin needs along with Humalog or NovoLog at mealtimes, varying the dose according to pre meal blood sugar and appetite. This will solve the syringe problem.

I wonder too if you aren't taking a lot more insulin than you need which make you overweight and insulin resistant necessitating more insulin. Talk with your doctor about the possibility of adding one of the medications called an "insulin sensitizer" [which includes [metformin and the thiazolidinediones].

DOB

Additional comments from Lois Schmidt Finney, diabetes dietitian:

Have you considered using an insulin pump? The pump can hold up to 300 units, so you should only be injecting once every two days.

I cannot find any syringes to hold over 100 units. You might wish to discuss with your diabetes team that you divide those two injections into four injections since you are already taking that many and should be able to get better control that way, also.

LSF

Additional comments from Dr. David Schwartz:

Perhaps you and your doctor should discuss the potential benefits and issues with switching you to a long lasting insulin product such as Ultralente (generally given twice daily) or even insulin glargine (Lantus), generally given once daily. This might solve your syringe problem, as might dividing the insulin into more than two doses per day.

Since you have typeá2 diabetes, I presume that you are following a meal plan, have lost the weight and have increased exercise that your doctor has recommended. You did not indicate whether you are also taking any of the oral hypoglycemic agents that can help sensitize your body to the effects of insulin and allow your insulin to work better. Perhaps Regular insulin would be a better choice for you than Humalog.

Please discuss these options with your doctor. If you have not had a recent referral to an endocrinologist, you might request one.

DS

DTQ-20021018012143
Original posting 23 Oct 2002
Posted to Blood Tests and Insulin Injections

  
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Last Updated: Tuesday April 06, 2010 15:09:38
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