Insulin pens

With reusable pens you can replace the insulin cartridge (also called penfills). When the cartridge runs out or expires, it is removed from the pen, thrown away and a new cartridge is fitted into the same pen.

In New Zealand, insulin is supplied by Novo Nordisk, Eli Lilly and Sanofi-Aventis. It is important to use the correct insulin brand in the correct pen, eg, Lilly pen will use Lilly insulin cartridges, a Novo-Nordisk pen will use Novo-Nordisk insulin cartridges, etc. Reusable pens are available at no cost from diabetes clinics and pharmacies.

These pens have an insulin cartridge pre-fitted into the pen that can't be removed. When the insulin runs out, the pen is thrown away and a new pen is needed.

Insulin pens are not pre-fitted with needles. A suitably sized needle has to be attached to the pen. In New Zealand, pen needles from 4 mm to 12.7 mm in length are available. The recommended pen needle size to use is 4mm.

• Current guidelines recommend 4 mm pen needles in adults and children regardless of age, sex, ethnicity or BMI, because they are long enough to pass through your skin and into the subcutaneous tissue, with little risk of IM (or intradermal) injection.
• A 5 mm pen needle may also be acceptable for people who are obese.
• Needles greater than 6 mm are no longer recommended because the needle may pass through the fatty skin layer and inject deeper into your muscle. 

A new needle should be used with every injection. In New Zealand you can have 200 subsidised needles. If you need more than 200 needles in a 3-month period, you will need an additional prescription, and this will still be free.

Your healthcare provider will show you how to use your insulin pen. The following steps are a guide.

The following is a a guide to using your insulin pen. If you are unsure about any steps, check with your healthcare provider.
Wash your hands with soap and water before an injection Attach a new needle to the pen. Don't throw away the inner needle cap. You will need it to safely remove the needle after your injection.
Prime the pen  This is also called a 'test shot'.  Remove the needle cap. Dial up 2 units and press the plunger, so that the insulin is injected into the air. This is to check to see if a good flow of insulin comes from the tip of the needle. Repeat until insulin does flow freely.
Select the dose Make sure the dose window is at '0' before dialing your dose. Check to see that you have enough insulin in the pen for your dose. Try dialing your dose. If the pen doesn’t let you dial your dose, then you don’t have enough insulin left. Your dose cannot be dialed past the number of units left in the pen. If you don’t have enough insulin, use a new pen or add a new cartridge to the pen.
Inject the dose by depressing the plunger Press the plunger and leave the needle in your skin for 10 seconds before removing it. Counting to 10 will make sure that you get your full insulin dose. After counting a full 10 seconds, release the button and remove the needle from your skin. Read more about insulin injection sites.
After the injection, remove the needle from the pen Remove the needle from your pen and dispose of it into a sealed sharps container. Do not leave the needle on the pen until you are ready to use it. This could affect the sterility of the needle, and change the dose of insulin given when you use the pen. Keep pens and needles separate until you are ready to inject, and remove the needle immediately after use.