Urgh. Ugly
One of the many wonderful features of diabetes is the sheer, damned boredom of it all. Diabetes is generally about the day to day uneventful plod of checking our blood glucose and balancing carbohydrate and insulin intake. While there are sometimes the exciting peaks and troughs of extreme hypoglycemia and hyperglycemia – which do, admittedly, add a certain frisson of excitement to the daily toil – generally not much of any interest happens.
The one glimmer of interest that appears briefly through the fog of general boredom is the gadgets. In my limited experience, it’s common among diabetics, especially of those within a certain demographic (I’m essentially talking men in their 20-30s here), to have an ongoing obsession in the latest shiny stuff marketed to the pancreatically-challenged hoards by our favourite friendly pharmaceutical conglomerates.
A great example of this is the hype concerning the new Bayer Contour USB glucose meter within the blogosphere (I really hate that word – it creates an air of an important, unified community of useful social commentators; which, of course, we all know doesn’t actually exist; most blogs – especially this one – are made up of an ill-informed, soupy conglomeration of poorly written rants and miss-enlightened opinions that no sane person cares about. But I digress).
Anyway, lots of people have been burbling on about how they’re looking forward to Bayer’s new funky colour screened wondrousness arriving on the market for our joyous consumption. All this goes to prove my point – us diabetics love our gadgets and shiny things.
So, with this in mind, why are the insulin pens us pump-challenged people depend on so damned ugly?
For example, I was idly examining my lantus-enabled AutoPen 24 earlier today and noted its vile, tacky cheap plastic feel. It really is a horrible pen – like something you would win in a disappointing set of Christmas crackers. Similarly, my Lilly HumaPen “Luxura” which I use on a daily basis to squirt humalog into my stomach is hardly as luxurious as the name implies. If, to use an tenuous analogy here, luxury is defined as the Presidential Suite of the five star Balmoral hotel in the heart of Edinburgh then the so-called “Luxura” pen is a threadbare, slightly sticky carpeted, one star Travel Tavern situated near a busy junction on the Norwich bypass. Not so good.
Over the next ten years I’ll stick in just under 15,000 injections (unless I finally get my pump, but that’s another story). So please, beloved pharmaceutical companies, please can you come up with a pen which looks great, works well and helps to stave away the horrendous boredom of diabetes!
Hello – it is not just men in their 20-30s. You should have seen everyone on my DAFNE course when it got to the bit where we all got updated meters/pens. You would have thought it was Christmas.
I quite like my humalog pen which does 0.5 units, it is a great green colour – I am so sad.
@Rachel Is that the kiddy-aimed pen that’s a really vile luminous green (I think there’s an orange one too)? If so, I had one of those a few years ago and actually quite liked the pen (not the colour scheme though…)
@Tim It is the same as the 1 unit dark red one, but green. I used to have a kiddy’s one, which had elephants on it, I loved that pen.
@Rachel Coo! I didn’t know that existed.
It is worth noting that at the IDF World Diabetes Congress in Montreal back in October 2009, Novo Nordisk announced it would introduce (in some countries, I believe it already has) a new pen called the NovoPen Echo, which is functionally similar to Lilly’s Humapen Memoir, featuring a memory of dosages, times and dates, but looks more like the Novopen Junior in design and also includes 1/2 unit dosages (unlike Lilly’s Memoir pen, more similar to the Luxura which allows 1/2 unit dosing), and I believe the Echo pen also has a lighter weight making it more portable. Of course, I personally hate Novorapid/Novolog insulin, for me it is as slow as regular insulin and twice as expensive, but hopefully competition will force others to offer similar pens!
that bottom one is an autopen?? I’ve never seen a white one before! Mine’s green!
“… most blogs – are made up of an ill-informed, soupy conglomeration of poorly written rants and miss-enlightened opinions that no sane person cares about…”
Brilliant.
And in that light let me say that I wrote on my blog that I thought the Bayer USB was cool too.
The ancient amongst us will remember the beauty that was the original novopen. It was a slender, brushed steel pen, elegant and robust. I was distraught when I had to swap it for the tacky plastic crap they replaced it with. That was a major step backwards in diabetes design.
I tend to hide my Lantus-loaded Autopen. It’s a disgrace. The B&O designed Novopen is a design classic. For you diabetes-gadget-geeks this site is rather sexy: http://www.yankodesign.com/2009/07/16/be-flexible-with-diabetes/
Phwoar! Sexy!
@Alison I was trying desperately to remember the name of that pen so I could use a picture of it to accompany the article. It won design awards and what-not didn’t it?
@Scott A pen with a memory would be useful; sometimes I just *cannot* remember whether I’ve put in my humalog or not and I’m reduced to scrabling through the bin to see how many discarded needles there are…
@Tim
What will I do when diabetes is no longer the fashionable chronic disease? Surely asthma isn’t as cool.
Are pump-enabled readers allowed to comment on this one? I think the ideal pen would be as light and small as a disposable syringe, carry a 100u cartridge and have a 1 or 2 dose memory. These days I carry a 0.3ml disposable syringe in my emergency kit rather than a pen.
Marc uses the Novopen 4. It’s probably one of the better looking pens but quite heavy! http://www.zsdg.ch/shop/catalog/images/novopen-4.jpg
I used to have a humapen memoir. I was so excited when I got it, as I have terrible trouble remembering whether I have had an injections sometimes, nevermind how much I had. I thought it would be the answer to my problems. However it was rubbish. Half the time the digital display did not work, which meant you had no idea how much you had dialled up as there weren’t numbers on a manual dial like normal pens, the only way to work it out was to count the clicks as you turned the dial. In the end I stopped using it, very disappointing.
@Rachel Oh, how depressing
@Aileen I think I had one of those when I was first diagnosed for a little while – it was quite a nice pen.
You’re absolutely right, asthma isn’t nearly as cool diabetes – especially Type One, which is far, far cooler than Type Two.
lol! I’m Type 2 with asthma! But, it’s a total walk in the park when you have experience of a Type 1 also.
@Aileen
ops, spelling sorry!
@Aileen I knew that comment would offend at least one loyal reader! 🙂 I think it calls for an entire article in its own right, so I can alienate more of the readership 😀
Type 1 asthma is cooler than type 2? Who would have guessed?
@Bennet Your levels of pedantry are impressive 😀
Anyway, returning to the point – I think we’re all agreed that Type One diabetes is the coolest of the chronic afflictions. Asthma, epilepsy & thyroid problems just don’t get a look-in in the coolness stakes!
Our Frank has a Lantus autopen. As a tactile experience it’s even worse than those rubbish biros they send out free from charities in the hope that you’ll buy some of their raffle tickets in exchange. Pah!
@Tim
Building on this, Tim. Diabetes and depression are a common topic. Maybe a therapeutic concept would be to foster some kind of pride in your chronic illness. Form a community, be part of “the gang”, without being elitist.
I’m doing a DAFNE in a couple of weeks, I’ll seed that into the discussion and hope not to be evicted for the derailing the proceedings.
Seriously, that’s how I got myself through post-diagnosis. Accept it, get over it, manage it. Obviously this applies to adults only.
Alex, unashamedly Type1
Hi everyone, I’m your obligatory Type II Mole… or at least I thought I was until I saw Aileen’s post up above. I’ve been type II for about 25 years but became insulin dependant in 2005, oh what joy!
I have to say that as pens go, I love the NovoPen 4 that I use for NovoRapid, far, far better than its predecessor, with a readable dosimeter and a nice steel finish. For Lantus I use a Sanofi Aventis Optipen Pro 1, a bit more fiddly, but it feels solid and robust though a bit prone to failure so I always keep a spare. My gripe is that none of them deliver more than 60 units, meaning multiple injections per dose for me.
I laugh about you youngsters wailing about having to inject 14 units, tosh! Piffle! I inject enough insulin in one hit to fell a moderately large ox! Hypo? Bring it on I say, I wish I could have a hypo, at least I wouldn’t be turning my feet into turnips!
Anyway, I reckon this blog treats diabetes exactly as it should be treated, with great levity and a serious undertone. Unlike you poor benighted souls, I had about 40 years without having to worry about my HbA1c or whatever the @**@ it is, but I’m glad to see you manage to live a relatively normal life. Go Guys!
Anyway, enough for a first post… where’s that bar of chocolate… ho-hum… another 80 units of NovoRapid…
@Teloz
Just wanted to say hi Teloz! I’m only just over 4 years in, but the thought of the future terrifies me. I really hope some other way of administering insulin comes along very soon, for everyone.
Aileen
@Aileen
Hi Aileen… don’t hold your breath chick! ;o)
@Lesley
I was going to go on a pump Lesley, but NICE wouldn’t fund the trolley, the generator, or the ten gallon drum of insulin…
http://i128.photobucket.com/albums/p167/Teloz/HilariousSmiley.gif
@Teloz Wow – more than 60 units in one go? I thought my pen just went up to 60 to allow for more convenient suicides. 😉
I think the most I’ve ever put in in one go is about 16 units for some sort of Bachanalian feast.
@Tim
That’s what I meant by enough to fell an ox Tim. I do 180 units of Lantus at night which takes three injections, and around 80 units of NovoRapid before a normal meal. I can do that with one injection though, using the NovoPen I can keep the needle in and dial up another twenty units.
I was doing all right until I had to give up the Metformin. 🙂
@Terry Ozbourne
Goodness Terry these are frigtening amounts. I know Type 2’s need more insulin due to resistance, but that’s much more than I expected. Think I might rather hold my breath! Is Metformin no longer an option? I know Marc (my son, he’s nearly 17) much prefers the novopen 4 so much so he won’t use any other pen. He dialed up 60 units today to see what it was like, wait till him it’s 180u you have to take. My diet starts tomorrow… 1 unit frightens me never mind 180. Long live my ability to take metformin!
@Aileen
I was taking Metformin for twenty years, and although I’m one of those lucky people who rarely suffer side effects from drugs, I must have developed a sensitivity to it. It manifested itself with colitis like symptoms and gave me a very scary and uncomfortable two months before we (the doctors, nurses and me) realised the cause. I could have done without the flexible sigmoidoscopy though! 😀
The upside is, that although I’m injecting ox-felling quantities of insulin now, my control is much better, I’ve been forced to realise that if I want to eat I shoot up, or if I don’t want to shoot up I don’t eat… a fundamental truth. 🙂
Not all insulin pens are clunky pieces of junk. I harassed my diabetes nurse here in NZ until she gave me a couple of these (http://mylillypen.com/) I got the two on the left, which dose in 1u and 0.5u increments. They are made of metal, and have a nice weight and a good satisfying click when you dial them up. They come in a spring-lid leather protective case, which can take an extra 3 x needles and 1 x cartridge. I use them with Humalog insulin, but have also used them with NovoRapid.
And yes, the Lantus Solostar sucks. I feel bad throwing heaps of plastic in the bin everytime one runs out 🙁
@kaitake – yeah, the one on the left is the one I use. I still hate it 🙂
@tim, haha true, I wasn’t reading your post properly was I! D’oh! Oh well, I guess you will never fall in love with an insulin pen. They do stab you, after all 😛
Yay! I gotta new pen! Well, two to be precise, one in use and one spare. The new beast is called a Sanofi Aventis OptiClik, and basically it’s an updated version of the Optipen Pro that we all know and hate.
Essentially, it’s a cross between a reusable and a disposable pen. The cartridges come in a disposable mechanism that includes the screw device to operate the plunger. The ‘operating system’ has the push-button and a digital counter much like the Optipen Pro, but bulkier and more sculpted, the cartridges can be a bit tricky to insert initially, but it becomes much easier with practice. The overriding benefit for me though, is that it will deliver a maximum dose of 80 units in one hit, so with a bit of judicious dosage correction I can save myself one injection a day.
Using the new pen I’ve dropped my nightly Lantus dose from 180 to 150 units (2 x 75) which means I get four doses per cartridge, no waste and one less needle. To enable this I have to be much more punctilious about injecting the NovoRapid if I even think of food, and more careful about my diet too. I might even have to start learning the black art of carb counting, though truthfully, I have no problem counting carbs, I just have no idea how they relate to insulin dosage.
To sum up then; the pen is a bit ‘clunky’ and not the easiest pen in the world to use (unlike my favourite NovoPen 4), but it works so much better for me I’m willing to put up with it.
If it works, you can use this link to have a look at the OptiClik.
Clicky Here
Thanks @teloz – that does indeed work!
@Tim Blurry ‘ell matey, that wos quick! 😉
@teloz – faster than the eye can see!
Ahaha, good post. I now feel guilty about selling “threadbare, slightly sticky carpeted, one star Travel Taverns situated near a busy junction on the Norwich bypass”.
@rosief – good! 😉
I’ve got a Novopen 4 in metal and it’s the best one so far to look at. The added bulk when they went from 1.5ml cartridges to 3ml a lot of years ago has never really been lost though. I was given the option of the coloured plastic ones but prefered one that will match my hair colour in a few years. A big improvement on the 3 with a lot softer push down but memory and half-units would make it ideal. I believe there are push on needles aswell but at the moment I’ve still got the screw ons.
Tech is always good and if it’s free even better!