20 April 2016
Using insulin cartridges or prefilled disposable insulin pens with syringes can lead to overdose resulting in significant harm.
The Primary Care Diabetes Society (PCDS) has issued a statement on the use of syringes to draw insulin from sources intended for use in pen devices. This is not endorsed by any insulin company and an ‘unlicensed activity’. It is particularly harmful as it can lead to contamination of the insulin, and incorrect dosage as the design for insulin cartridges varies significantly from insulin vials designed for syringes.
Insulin from pen cartridges and prefilled disposable devices is not designed to be used with syringes, and there is no data to support this practice.
Why are people doing this?
- Types of insulin that are not available in vials for use with syringes, such as Insuman® Rapid.
- Personal preference or impaired manual dexterity may make it easier to use syringes instead of the insulin pen.
- Lack of knowledge or experience of using insulin pens.
- Malfunction of the pen device.
- Policies preventing particular community nursing teams from using insulin pen devices.
What should they do instead?
Some of the solutions and recommendations from PCS include:
- Consider different options for insulin available in vials for individuals unable to self-administer using a pen device
- Provide better support and training so that people with diabetes and healthcare workers are able to use the pens safely and efficiently.
- Only using syringes with cartridges in case of an emergency and if there are no other options available. However, it is imperative that the cartridge or prefilled pen is discarded
There is a risk of NSI for third-party administration using a pen device, which is why certain organisations insist on the use of insulin syringes. In this case, safety-engineered pens, which are widely available should be considered.
Cartridges and pens should be used in accordance with manufacturer instructions.