Lantus Solostar pre-filled pen releasing insulin when pressed on zero setting

Just noticed that with the solostar lantus pen dose setting at "0" when pressing the injection button some insulin is released.

Anybody noticed that or is it just a faulty pen?

I started looking into the pen operation after getting hypos even with reduced lantus dose. A few months ago I split the lantus dose from 10 units at bedtime to 4 units at 11pm and 5 units at breakfast time (at same time as the pre-meal novorapid). I recently started on a new lantus pen and soon after started to get low BGs in the afternoon and below 4.0 mmol/L pre evening meal. Reduced the morning Lantus dose to 4 and the low BGs still happening, Checked the instructions for counting to 10 after injecting to see if one should press the injection button whilst counting and the instructions say that. Then testing the pressing down of the button and noticed the release of the insulin when on setting of '0'. So I am coming to the conclusion that either the pen is releasing more than the set dose whilst counting to 10 or maybe I sometimes do several press and releases on the injection button whilst counting to 10 (can';t keep finger steady in one long 10 second press) and now I think the press and release after the dose counter reaches the "0" setting must be releasing more insulin.

I will ring the manufacturer tomorrow and get an order through from GP (it is my last pen - should have ordered earlier).

Has this been noticed by anyone else?

I would say it is likely for very small amount to be released when you apply pressure to the plunger even when at 0........the pressure inside the glass cartridge must be great......

Test some other pens to see if they are the same, you might find they are. You could also try and compare the insulin quantities by skooshing them onto a side plate or something similar......skoosh at 0 and then skoosh 1 unit to another plate, you may find that the 0 amount is much smaller than 1 unit and so probably not responsible for lows.....

I personally always count to about 6 after the injection is complete, but I dont continue to press the plunger........

i rang sanofi uk and they put me through to the quality team. the lady tried a pen and her test pen also released insulin when end pressed down and setting on "0". Took details and will have it investigated

advice meanwhile not to press too hard when counting 1-10 seconds after injection and not to release finger and press again as that would leak more insulin through. Of course by splitting the dose I have doubled the error margin as there would be two lots of counting to 10 and releasing more insulin ! They asked if I made my diabetes HCPs aware - said will do.

I wonder f this is related to the issue I came across here
http://www.diabetesdaily.com/forum/multiple-daily-injections-mdi/33202-apidra-lantus-solostar-pens-possible-leaks

By the way the Novopen 3 I use for the novorapid does not release a single drop when pressed at "0" dose setting - so this is a solostar pen issue

My Novorapid FlexPen from Nordisk does the same when you plunge at zero...........

My Novorapid FlexPen from Nordisk does the same when you plunge at zero...........

I sprayed the 0 and 1unit on to my table at work just there and it was about half a unit that came out, so if someone is relatively sensitive to insulin, then a half unit could make the difference, however, this extra is when you continue to press on the plunger after it has completed its journey back to the 0 position, which is not common practice in my experience.....

some months bak I switched from the flexpen to the "novopen 3 demi" which gives me half unit doses.

The demi pen is not leaking any insulin when end pressed at "0" dose.

My Novorapid FlexPen from Nordisk does the same when you plunge at zero...........

I sprayed the 0 and 1unit on to my table at work just there and it was about half a unit that came out, so if someone is relatively sensitive to insulin, then a half unit could make the difference, however, this extra is when you continue to press on the plunger after it has completed its journey back to the 0 position, which is not common practice in my experience.....

Insulin Test

the top is at 0, the bottom is 1 unit...

Thanks James for trying it on your pen. I tried a new lantis solostar pen and it does leak with "0" dose - in fact the longer you leave it the more it leaks. I will switch to a new pen anyway.

So it could be just a combination of changes that led to the problem for me.

• 1. Splitting the dose doubled the error caused by the leak after reaching zero
  
• 2. When counting 1 to 10 I recently switched to counting one thousand, two thousand ... up to ten thousand as I thought I was rushing through the 1 to 10 !
  
• 3. Probably pressing harder now on the end when counting - because dose is tiny and didn;t want to lose any of it (just 4 and 4 units)
  

Tried to replicate your problem with my current Lantus Solostar pen but without success. Get 2 drops out of a 0.23 mm diameter x 4 mm needle as worst case.
Must say that I unknowingly follow Lantus instructions as to injection method and when injecting hold button down until 10 seconds is up.
Only other thing that I could think of was that if it was first use - and the pen was still normalising temperature to ambient after removal from fridge - there would be slight pressure within the pen which would be released when pressed - even on 0.
Personally on first use of a new pen I wind it all the way up to 80 and wind it back again to 0 as I have found sometimes the mechanism can be a bit sticky, particularly if thumb not exactly on the centre of the button and it can seem to lock and the insulin is delivered in spurts. Does not fill me with confidence about correct dose applied.
Have found that my pen initial wind-up does the trick though and have had no further sticky dose applications.

Regards
Garry