Levemir clogging needles

Until recently, I was on one daily dose of Levemir. This meant I used one needle for my QA (Humalog) and one needle for my Levemir each day (hopefully saving the NHS a bit of money - plus I don't like wasting things) and this worked well.

My HCP suggested that my control could be better and I should change to 2 daily doses of Levemir. I intended to continue using one needle for my QA and one needle for my BI. I found that that when it came to my second dose of Levemir, the needle that I had used for my morning dose was clogged, so I had to use a new one.

Has anybody else noticed this?

Hi Alan,

I use Levemir twice a day but cannot comment on your problem as I use needles once only, as you are supposed to do. If you had read the articles that I read about needle use you might be more concerned with your own health than economising on needles. Compared with the amount of money wasted by the NHS the amount such economies can save would not even register.

If you re-use needles then the needle is open to the pollutants in the air for the hours between each use (the cap is not a reliable seal, and of course contains air when you replace it). If the needle remains attached to the pen then any contamination entering the needle can prgress to the phial in the pen. The thing that really got me though, in the article, was the description, backed up by highly magnified photographs, of the burrs that are created at the end of the needle each time it is used and the damage these burrs do to your tissue. This leads to increasing difficulty with injection sites over time.

Kind regards.

Roger

Totally agree with Roger. When I did DAFNE in Feb 2007 the educators checked my injection sites and pointed out lipos (lumps) on my thighs where I had been injecting lantus using needles multiple times. The "blunter" needles were a significant contributer to this, and of course as well as not being a good thing in its own right, it was having an adverse impact on insulin absorption rates. If we're into costs, I'd suggest that the costs to the NHS resulting from diabetes complications will far outweigh costs of single needle use, but what is it with diabetics and guilt (me included)?

Stew

Hi,

Are you guys talking about the old syringe type needles or the screw on pen type? I reuse my pen needles until the insulin runs out (about a week), change the cartridge and the needle.

Never had any issues, what sort of complications are you expecting from this? Interested / worried!

Phil

I will be honest and say that I only use one needle per disposable pen.......so far my control has not been effected and there have been no lumps etc...........

I also take 2 doses of levemir like you and just use 1 needle per pen......

What do you mean when you say its blocked. I assume you prime before each injection, this would/should clear any blockages.......no?

I can't even prime the pen - nothing comes through at all, even after several attempts - this happens 9 times out of ten, so I don't even try the old needle for my second Levemir injection now.
When I has first put on Levemir, the Consultant told me that when you inject it, it crystalises - thus contributing to its prolonged effect. I wonder whether it does this if left in the needle after the first injection.

Alan,

Strange that novorapidboi26 and I don't seem to get this issue and he is on the diposable pens and mine the NovoPen 3 so that rules out the pen. Unless your pen is broken/faulty?

Have you spoken to anyone at the hospital about this? Just seems odd.

Phil

as this is a confession thread, forgive me I have sinned. I also re-use needles and have never had an issue, certainly never had a problem like Alan. I have to say basic physics suggests the pressure exerted by the plunger on the needle to expel insulin should be such that when priming it should be pretty difficult for it to clog, any crystalised Levemir would be pushed out of the needle. This all suggests that it is the pen and not the needle that is the root cause of the problem.

I don't think it's a problem with my Novopen 4, because it always works fine with a new needle.
I usually dial up 2 units when I prime my pens (I think this is the recommendation). Last night I tried the morning needle, but primed it with 4 units and this worked fine. I'll try this again this evening and see if I've cracked the problem.

Thanks for all your suggestions.

Any developments?

I usually do about 4 units, sometimes more, when priming.......

I would still suspect a faulty pen, as you say it keeps happening, even if it works with a new needle the first time............

you could try and test the same batch of needles with a spare pen...(which you should have, however not everyone does, tut tut....).......

for complete peace mind new pen and needles wouldn't hurt.....