Insulin Levemir Flexpen (Gestational Diabetes)

[AR23]

Hiya,

I'm currently 33 weeks pregnant with gestational diabetes and have just been put on insulin. But due to the festive holidays, there weren't many staff around (diabetes midwife specialist etc) and so I haven't really been shown how to use the pen. I have watched a couple of YouTube videos but I still have some uncertainties so thought I'd ask on here.

Soooo....I had lots of problems with this prescription initially because the pharmacist kept rejecting it as it wasn't written "correctly" etc. I have the Levemir FlexPen and my dose of insulin prescribed is 2 units a day.

1. Is it normal to bleed a little at the site of injecting? There was no blood in the YouTube videos so I wasn't sure if I'm pressing too hard.

1. The needles I have been given are "TriCare 4mm 32 gauge". The pharmacist also rejected my prescription because the consultant hadn't written what type of needles I needed. So I went back and got another prescription, but as far as I can remember, I don't think it was this brand....the needles however do fit into the pen lol, but has anyone else used these specific needles with the Levemir Flexpen?

1. Are you supposed to dispose/remove the needle straight after using, or can you leave it in there until you next need to change the needle?

As long as the needles fit securely on to the pen it will be fine, and 4mm is a fairly common size so should be fine. I would normally advise people to throw away the needles in a sharps box straight after they use it to avoid them accidently jagging themselves next time they get the pen if they forget the sharp is still there. Some diabetics reuse needles, but I'd always advise using a fresh one!
A small amount of blood can be normal, just apply a little bit of pressure after for a few seconds. The most important thing is you leave the needle in place in your leg for 10 seconds after you have pressed the button to make sure all the insulin goes in.

Just to check since no one has really gone over it with you, are you priming the needle? You should always dial the units to 2 and press the button to make sure there are no air bubbles etc in the needle etc. When you press the button you should see a little squirt of liquid come out the top, this means the needle is primed and ready to use. If you don't see that, just repeat with another 2 units until you do.

Just to say, I work with children so know a bit about diabetes care but nothing about gestational diabetes! But this is how I would give insulin for a child.

Hello,

I've been using insulin for a few weeks, so will tell you what I was shown at the demo in hospital and what I've found.

1. re leaving the needles in, no you can't do this (I asked, as thought it'd be easier than carrying around a sharps container). When you take the needles out the pen is apparently sealed and sanitary, but if you leave them in then it opens the pen up for contamination
2. bleeding - sometimes very occasionally but not usual. I inject in the front of my thighs. Pinch about 2 inches of skin, slowly insert the needle, release the skin you're pinching, press in the dose and hold it in the skin for 10-15 seconds before slowly removing. Sometimes I get blood or a bruise but most of the time I don't.
3. on my repeat prescription I've been given different needles by the pharmacy - they fit so I'm using them but the original ones were slimmer and easier I think

Good luck, it does get easier to inject yourself honestly

Aww thank you @IwillrunIwillfly and @A1b2c3d4e5f6g7

I just watched another video which mentioned the priming bit, I wasn't doing that before, so thanks very much. I was also leaving the needle in until use out of laziness, but I will start to remove it now.

It'll be my 3rd day today, the 1st day I just couldn't get myself round to stabbing myself ha (I'm a bit of a whimp)!

Oh and do you store the pen in the fridge after each use or can it be left out at room temperature once you've started using it? The instructions in the box weren't very clear, it says in the fridge until before opening. Then can it be stored in the fridge OR at room temperature DURING use for up 6 weeks. My dose is prescribed at night before bed, so it would be a pain to go down to pop back in the fridge after using, especially because I have a super sound sensitive 2toddler too.

You can leave it out of the fridge but make sure it doesn’t go in freezing temperatures or get too warm (over 30° or so). My teen son left his insulin on a sunny windowsill whilst staying at a friend’s and it killed it, resulting in high bloods. 🙄

I would guess all insulin pens should be stored in the same way. That is - the one you are using can be left in the room, but those that haven't been used yet - keep in the fridge

You need to remove the needle and stick in a sharps bin straight after use. Once open you can leave out at room temp (it's better in fact as less stingy at room temp).

As for blood it happens occasionally. If it happens every single time then speak to the nurse. Make sure you are changing the spot you inject every time as well.

Yes as others have said, for the pen you are using, out of the fridge for a month. Hurts less than when it's cold.

And yup I was such a wimp about the needles and the finger prick tests, used to have to psyche myself up, but doesn't phase me now.

My son is a type 1 diabetic and I am a support worker for a type 1 child.

I will probably be repeating most of what others have said but maybe it will help... :)

Occationally you will bleed slightly at he injection site if you catch a capillary under the skin. This is unavoidable, perfectly normal and will stop with light pressure though it may bruise slightly. When injecting, remember to ensure you are rotating your injection sites - my son injects his thighs and stomach, you may be just using your thighs. Remeber to use a different leg each time and move around a bit. The muscle in your thigh is quite large so use the space you have! Injecting inthe same place repeatedly can cause fatty lumps to form under the surface of the skin that will effect how your insulin is absorbed, rotating and moving around will hopefully prevent this.

Like a PP has said, prime the needle be squirting two units up and away from you to check the needle is working and the insulin squirts out - we have had instances where the needle has not worked but if the needle had not been primed we would not have known this. Also, (as already said) ensure it is inserted for 10 seconds to make sure all the insulin goes in.

Your needles sound fine for your pen. There are many types of needles and with very similar names so its possible that is why your pharmacist needed clarification.

Absoluetly make sure you are disposing of your needle straight after using it. This is to avoid contamination of the insulin and prevent you/anyone else accidently getting pricked. Also, the needle has been inside your skin and now has your bodily fluids on it, it needs disposing of in the correct manner in a sharps bin.

The pen you are using is fine to be out of the fridge at room temperature during the day - avoid it being next to radiators etc. Store unsused insulin in the fridge. If you need to use a new one, take out of the fridge about 3 hours before you need it as cold insulin being injected can feel uncomfortable. My son uses his insulin faster than you do but I would advise you to mark on the calender when you start using a new one and when you need to start the next one. You may find you have several units left but if you use it after the time stated, it wont work as well and will affect your BGL.

This may not happen with you but I occationally have to be firm with the GP surgery to ensure we have enough equipment - blood sugar testing strips, needles, lancets. He uses between 38-48 per week depending on exercise/hypo's etc and they seem to think a box of 100 will last a whole month! His control of his condition is perfect so we know we are doing everything correctly and what we request meets his needs. His diabetic specialist nurse said being firm is occationally required as GP surgeries often have little knowledge of what level of equipment is required but if you need it, you need it.

Thank you everyone for your replies, very helpful indeed. I think I'm getting the hang of it, my morning reading today after injecting the insulin last night correctly was all under control so hopefully That shows that the insulin is working. Let's see how it goes over a few more days :-)

Just a tip for the nervousness of jabbing yourself, when i used pens for IVF injections, I would press something cold on my belly for a few secs before injecting, then hardly felt it. Also less bleeding if the site was a bit cold first.
Also the belly is much less painful I found than thighs. It should go into fat not muscle so its easier to pinch belly fat than thigh fat. If you do it on top of your thigh you might hit muscle. Although I haven't experienced doing it into a pregnant belly so others may disagree.

I got used to it after about 5 days.

@Zibidee thank you so much, I'll try applying an ice pack or something to make the area cold. I've been advised not to inject into the stomach area as I'm pregnant, so either arm or thighs.

Fair enough, I can imagine the sense in that. But yes, do ice. I used to sit a bag of peas from the freezer on my belly just while getting the injection ready, that was enough to numb it. Should be the same with thigh. Make sure you do the fleshy part.