Conversion with Syringes

[DerbyMom]

Help would be most appreciated. When Derby was first diagnosed last May, the vet provided a prescription for Novolin N insulin and he gave me U-40 syringes which I continually used.

It was not until I went to my new vet in Florida was I educated about the difference between U-100 insulin and U-40/U-100 syringes. I had no idea and the previous vet never explained the importance or difference to me.

The good news is that Derby is well regulated on insulin. He is tested twice a day and I am able to keep his insulin dosages pretty consistent with small adjustments depending on his glucose readings.

The problem is that I am buying new U-100 syringes to match the U-100 insulin.

Derby's regular dose (again adjusted depending on his glucose levels) is 5 units using the U-40 syringes with U-100 Novolin N insulin.

When I start to use the new U-100 syringes, how do I arrive at the correct dosage if 5 units is his normal with the mixed insulin/syringe?

So, 5 units of U-100 using a U-40 syringe equates to ???? units of U-100 using a U-100 syringe?

Any help would be appreciated.

[DerbyMom]

Re: Conversion with Syringes

Derby is a 25 lb shih tzu mix approx. 15 years old.

He is tested twice a day, and his glucose levels can fluctuate but I adjust his insulin. As noted above, I am not sure what his "correct" dosage is since I have been using U-100 insulin with U-40 syringes as originally given to me by the vet.

But his dosage ranges from 2.5 to 7 units depending on the glucose readings that I obtain. If low below 120, it is reduced and if high (above 250) it is increased. I try to keep him between 120 and 200 in Alphatrak readings.

[CraigM]

Re: Conversion with Syringes

Help would be most appreciated. When Derby was first diagnosed last May, the vet provided a prescription for Novolin N insulin and he gave me U-40 syringes which I continually used.

It was not until I went to my new vet in Florida was I educated about the difference between U-100 insulin and U-40/U-100 syringes. I had no idea and the previous vet never explained the importance or difference to me.

The good news is that Derby is well regulated on insulin. He is tested twice a day and I am able to keep his insulin dosages pretty consistent with small adjustments depending on his glucose readings.

The problem is that I am buying new U-100 syringes to match the U-100 insulin.

Derby's regular dose (again adjusted depending on his glucose levels) is 5 units using the U-40 syringes with U-100 Novolin N insulin.

When I start to use the new U-100 syringes, how do I arrive at the correct dosage if 5 units is his normal with the mixed insulin/syringe?

So, 5 units of U-100 using a U-40 syringe equates to ???? units of U-100 using a U-100 syringe?

Any help would be appreciated.

5 in a U-40 would require 12.5 in the U-100 syringe to yield identical volume of liquid.

Craig

[CraigM]

Re: Conversion with Syringes

5 in a U-40 would require 12.5 in the U-100 syringe to yield identical volume of liquid.

Craig

To possibly confirm this, you might fill a U-40 to 5, and a U-100 to 12.5 with water. Then squirt them out to compare the volume (yea, could be hard to compare such a small amount).

Craig

[DerbyMom]

Re: Conversion with Syringes

Thank you, Craig. I am hoping someone with actual experience can confirm. This must be something that occurs every now and then when you use one type of syringe versus the other. I read somewhere that there is a multiple of 2.5 but I think that assumed U-40 insulin using U-40 syringes and wanting to go to U-100 insulin. I am already using U-100 insulin.

But I just want to make sure. But it seems my situation is a bit different since I have been using U-100 insulin in a U-40 syringe.

I need to get my insulin and syringes in sync.

[k9diabetes]

Re: Conversion with Syringes

Sounds like you were filling the syringe to the 5-7 mark. In which case you have been giving quite a bit more insulin than 5-7 units.

It is very important to understand the difference between "units of insulin" and the mark to which you have been filling a syringe.

When the insulin and syringe match, they are the same.

But in your case if you were filling a U40 syringe with N to the "5" mark, you would have been giving 12.5 "units of insulin".

So we need to know what mark on the U40 syringes you were filling to to know how much (units) of insulin you were giving.


Natalie

[DerbyMom]

Re: Conversion with Syringes

Sounds like you were filling the syringe to the 5-7 mark. In which case you have been giving quite a bit more insulin than 5-7 units.

It is very important to understand the difference between "units of insulin" and the mark to which you have been filling a syringe.

When the insulin and syringe match, they are the same.

But in your case if you were filling a U40 syringe with N to the "5" mark, you would have been giving 12.5 "units of insulin".

So we need to know what mark on the U40 syringes you were filling to to know how much (units) of insulin you were giving.


Natalie

Thanks, Natalie. I measure to the "5" mark on the U-40 syringes using Novoline N U-100 insulin.

[k9diabetes]

Re: Conversion with Syringes

Okay, then you have been giving between 12.5 units (at the 5 mark) and 17.5 units (at the 7 mark) of NPH.

So to give the same amounts in the U100 syringes, you fill those syringes to 12.5-17.5 since they now match.

[DerbyMom]

Re: Conversion with Syringes

Okay, then you have been giving between 12.5 units (at the 5 mark) and 17.5 units (at the 7 mark) of NPH.

So to give the same amounts in the U100 syringes, you fill those syringes to 12.5-17.5 since they now match.

Thank you so much for confirming. I am really good at adjusting the dosages as needed using the old U-40 syringes. I just now need to get up to speed using the new syringes.

[k9diabetes]

Re: Conversion with Syringes

To me, the easiest way to understand the difference between the insulins and their corresponding syringes is to think of something like kool-aid.

U40 insulins are like weak pale kool-aid. In every milliliter of a U40 insulin there are 40 units of insulin.

U100 insulins are long strong dark kool-aid. In every milliliter of a U100 insulin there are 100 units of insulin.

Same amount of fluid delivers a different number of insulin units.

The syringes vary in the size of the barrel.

Take a syringe that holds a total of 30 unit marks. The U40 syringe is wider inside and holds more fluid than the U100 syringe. It has to be because it is set to measure pale kool-aid and needs more kool-aid liquid to deliver the same amount of kool-aid units.

It can take a while to get your mind around it - I always have to double-check myself. But it's a good thing that you are learning how many "Units of Insulin" you are giving as any time you need to convey your dog's dose, such as here or to an emergency vet, you need to be able to accurately describe how many molecules of insulin you are giving.

Life will actually be much better now that you're going to U100 syringes. Many more choices of needles sizes, etc. and all matched up so no more calculations - just the first one now to know how much to give.

You can use the calculators to figure out how much you were giving - you just have to read them backwards. You can see the relationship between 5 units in U40 and U100 here:

http://www.felinediabetes.com/insulin-conversions.htm

[CraigM]

Re: Conversion with Syringes

Thank you so much for confirming. I am really good at adjusting the dosages as needed using the old U-40 syringes. I just now need to get up to speed using the new syringes.

Actually, your adjustments were huge. What sounded like a fairly large change going from 5 to 7 was REALLY a huge change going from 12.5 to 17.5. I seldom make an "adjustment" more than ½ unit in the U-100 syringe.

O'Well, you are on track now

Craig

[DerbyMom]

Re: Conversion with Syringes

Thank you both for your great help. I just wished the original vet had told me the difference - I honestly had no idea of significance of the U-40 label (I thought it was just a size of the syringe).

But with your great explanations, I have a better understanding. So, for the last 10 months, my 25 lb. mix has been averaging 12.5 units of insulin twice a day. And his glucose levels are normally between 120 and 200 and with a spike, I just adjust his insulin dosage.

I take the measurements twice a day (7:00 mornings/5:00 evenings) and then feed with approx. insulin dosage about one hour later. So far, he has been pretty regular. If there is a spike up, I increase the dosage and if he is below 120, I adjust down.

[DerbyMom]

Re: Conversion with Syringes

Just one more question, Craig. I see the type of food you are using - I was on Blue Buffalo Wilderness Small Breed Healthy Weight adding chicken and boiled rice.

The new vet suggested that I reduce the protein levels and recommended the Science Diet W/D formula.

I was reading and didn't see that the extra protein that was showing up in the BUN blood reading as a bad factor given that both of my dogs are senior (over 14)

What do you think? I really don't like the fact that the W/D is really mostly corn/grain in nature.

[CraigM]

Re: Conversion with Syringes

Just one more question, Craig. I see the type of food you are using - I was on Blue Buffalo Wilderness Small Breed Healthy Weight adding chicken and boiled rice.

The new vet suggested that I reduce the protein levels and recommended the Science Diet W/D formula.

I was reading and didn't see that the extra protein that was showing up in the BUN blood reading as a bad factor given that both of my dogs are senior (over 14)

What do you think? I really don't like the fact that the W/D is really mostly corn/grain in nature.

I really don't know. Annie is actually on Blue Buffalo Wilderness Rocky Mountain Healthy Weight for the past several months. I think it's 30% protein, which is higher than most kibble??

Years ago I think I read K9 diabetics might want food that was lower than average in fat, and higher than average in fiber and protein. The problem was (I think) in order for dog food companies to generally raise protein, they also raised animal fat which might not be good for diabetics. I think Annie's kibble uses various forms of peas to raise the protein and fiber without raising the fat content.

As I said: "I really don't know". I was having trouble last summer / fall with her not wanting to eat her meals, so I tried several bags of various kibble and she seems to be eating this one without much drama at mealtime.

Craig

[DerbyMom]

Re: Conversion with Syringes

Thanks for your insights - I will probably post this as a new thread since I think it is very important that the dietary issues are discussed. I am reading conflicting research and the vet isn't that clear on the detriments of protein except that my dog's BUN reading is a bit high. The Blue Buffalo Wilderness Small Breed Healthy Weight Chicken is 32% protein and 10% fat, with no corn/wheat or soy.