Over the last decade or so, we’ve seen a tremendous growth in insulin pen usage compared to other insulin delivery devices. It’s no wonder, given that the pens are easier to use than traditional methods, and come with a whole range of benefits for people with diabetes. With that growth has come tremendous competition in the insulin pen market, with many different options and devices available for many different uses. We’re quickly getting to the point where no matter what your specific need may be, someone manufactures a pen to fit it precisely. In fact, usually it’s several someones, giving people with diabetes an unprecedented choice in insulin pen delivery mechanisms.
So, which insulin pen should you use?
While you should always make the final decision together with your diabetes care physician, it’s always good to start that discussion by looking at your options and doing some preliminary research. That’s the point of today’s blog post – getting you the information you need to have an informed and productive conversation with your doctor. You should not use this article to make up your mind; instead, use it to give you some starting points for a more in-depth conversation.
Refillable vs. Prefilled
One of the first things to consider is whether you’re looking for a refillable pen or a prefilled pen. A refillable pen uses cartridges that can, obviously, be refilled (either by replacing the cartridge or by filling the insulin cartridges). Prefilled pens come with sealed insulin compartments and need to be disposed of after using.
Which one you pick is largely a matter of preference and availability. While refillable pens represent a larger initial cost (refillable pens tend to be significantly more expensive than prefilled ones), they are comparable in the long run since replacing or refilling cartridges is cheaper than buying disposable pens.
Prefilled, or disposable, pens are easier to maintain and represent a smaller up-front commitment. If you’re not sure what insulin regimen you will be staying on for an extended period, or if you tend to lose things, disposables might be the better way to go. Since pens are generally made for a specific type of insulin, changing your glucose control regimen might require getting a whole new pen, and could make a refillable pen a poor investment.
The three main insulin pens available on the market (and Timesulin works with all of them) are:
Novo Nordisk FlexPen (works with Novorapid, Levemir, Victoza, Novolog, Novolog Mix 70/30 and Protaphane)
Sanofi Solostar (Works with Lantus, Apidra and Insuman)
Lilly KwikPen (Works with Humalog, Humalog Mix 50/50 and Humalog Mix 75/25)
One major downside to pens is that requiring more than one type of insulin, rapid acting and long-acting for example, requires using multiple pens (or a pen and another delivery mechanism like a pump or a traditional syringe).
Different Pens for Different Insulins
Currently, insulin injection pens are all proprietary and tied to the insulin produced by their manufacturer. So an Lilly pen will use Lilly insulin, a Novo-Nordisk pen will use Novo-Nordisk insulin, etc.
What this means practically is that you need to pick a pen that offers the type of insulin you need, since not all pharmaceutical manufacturers provide all possible mixes and analogues available. Make sure to check with your physician that whatever pen you’re thinking about can accommodate your needs, and be ready to switch pens (no matter how much you love the one you have now) if it means better blood glucose control.
Most pens dispense insulin in one unit doses. This is fine for adults on a typical insulin regimen, but might not be ideal for children or for adults who don’t require as much insulin. For those cases, it’s important to find a pen that is capable of dispensing half-unit doses. Some pens only allow dosing to be increased by two units, and might only be practical for users with high dosing requirements.
Another consideration is the maximum and minimum dosing that a particular pen can provide. Pens range from having a minimum of one-half unit to two unit injections, while the maximums are all over the place, going from 20-30 units all the way up to 80 units.
Make sure whatever pen you prefer fits your insulin dosing requirements!
While almost all pens are considered easier to use than syringes, their ease-of-use can range pretty wildly. Some important points to consider are:
Readability of dosing input
Ease of setting dosing input (does it click or otherwise tell you when you add a unit, for example?)
Ability to dial-back over-dialed doses (some pens let you simply click back, others allow you to reset back to zero and start over, some don’t let you do either and require that you waste that dose)
Ease of inserting needles
Color choices or other marking choices (this is really useful for when you take multiple insulin types, since having each in a different color pen makes things much simpler)
For a quick reference on different pen availabilities, you can take a look at this reference guide (though keep in mind it’s about two years out of date). An even better idea is to talk to your physician and see if they can get you reference materials and possibly even samples of all the pens you’re interested in.
If possible, always take a sample pen and try it before placing a large order at your pharmacy, and try several variations from different manufacturers before settling on one. Remember, little things that might not be immediately noticeable when just looking at a pen can make a big difference in usability, and an easier-to-use pen will result in a much more pleasant daily insulin dosing regimen.
Finally, no matter what pen you end up going with, remember that we probably make a timer enabled replacement cap for it. Check out the selection of pens we support.