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��������������� ��� ��������������� INSULIN
MEASUREMENT DEVICES ���� Most diabetics,
blind or sighted, want and need to achieve control, independent self management, of their diabetes.� But
if a diabetic cannot rely on vision to accurately measure insulin, then, to maintain independence, he or she MUST have effective alternative techniques, specifically designed for individuals with partial
or complete vision loss.� Many manufacturers have risen to the occasion, and with the appropriate adaptive equipment, nonsighted self management is a reality.� People's abilities (and ramifications) vary, and it is important to remember that different devices best meet different needs. ���� Some diabetics,
with fluctuating vision, will find that at certain times of the day they can rely on their
vision to accurately measure insulin.� At other times their visual acuity may diminish, leaving them guessing at their
dose of insulin or relying on sighted aid.� A diabetic's eye condition can change daily, making reliance on visual techniques unsafe. ���� The following
is a catalog of alternative devices for insulin measurement.� Some are designed for those with partial sight.� Others
are intended from the start for nonvisual operation.� A few are the simplest of home made aids, some designed by resourceful blind diabetics.�
Note: Prices quoted do not include shipping charges. Insulin Measurement Systems ���� The Count
A Dose:� This insulin
measuring device is manufactured by Jordan Medical Enterprises, of South Pasadena, CA, and is available from the National Federation of the Blind (NFB).�
Cost:� $40.� Cassette instructions are available.� Order
from:� Aids, Appliances,
and Materials Center (hours of operation are 8:00 am to 5:00 pm EST, weekdays), National Federation of the Blind, 1800 Johnson St., Baltimore, MD 21230; telephone:� (410) 659 9314. ���� Designed
for the Becton Dickinson (B D) .5cc LoDose (50 unit) syringe, the Count A Dose holds two insulin
vials and directs the syringe needle into the vials' rubber stoppers.� The
user can easily mix two different insulins, and the "T bar" that holds the vials has
clear and obvious tactile marks to aid insulin differentiation.� Dose size is adjusted with the thumb wheel, which clicks for each
unit measured (clicks can be both heard and felt) up to
50 units. The device provides easy, reliable, and accurate nonsighted insulin measurement. ���� The Syringe
Support:� This device
is manufactured in Canada, and its instructions (standard print only)
are bilingual (English and French).�� In the U.S., the Syringe Support may be purchased (Cost:� $26) through: The Eye Dea Shop, Cleveland Sight Center, 1909 E. 101‑st
Street, Cleveland, OH 44106 8696;� telephone:� (216) 791 8118,
ext. 278. ���� The Syringe
Support uses only the B D 1cc/100 unit disposable syringe, and measures insulin in 1� or 2 unit increments, in doses of one to 100 units.� To mix insulins with the device, it is necessary to remove vials from
the apparatus.� To
draw a measured dose, the Syringe Support depends on a set screw with a raised flange, its only landmark, at 12 o'clock.� One full turn draws two units. One half turn draws a single unit.� Although the dial lacks definite tactile or audio indicators, in most cases
any error would be fractional.� Still, the Syringe Support performs best for those who must draw doses of greater
than 10 units. ���� The Load
Matic:� This device
is available (Cost: $49.95) from Palco Labs, Inc., 8030 Soquel Ave., Santa
Cruz, CA 95062; telephone:� 1 800 346 4488. ���� The Load
Matic allows two different measurement increments:� 10
unit and/or single units of insulin.�
It uses only 1cc/100 unit B D syringes.� Depressing the lever measures a 10 unit increment, and turning the dial
one click measures a single unit.� To mix insulins with the Load Matic, as with the Syringe Support, it is necessary
to remove and replace insulin vials from the device. ���� Although
an intriguing design, the Load Matic features an overly complex operating drill, with many opportunities for user error.� Ambiguous
and incomplete instructions take a high degree of familiarity for granted, and may confuse the inexperienced.�
Its 10 unit lever, if incompletely depressed, is capable of dispensing the unwary user
an incorrect dose.� The
Load Matic's cassette instructions tell the blind user to draw only about 700 units out of
an insulin vial with the device, as "this assures
that you will never draw air into your syringe instead of insulin."�
The printed instructions lack this statement.� The instructions make no provision for removing air bubbles from the
syringe, which can easily be accomplished by drawing four or
five units of insulin, reinjecting them into the vial, three times, and drawing the full measured dose the fourth
time (insulin mixers need do this only with their Regular insulin, the first they draw). Homemade Insulin Measurement Gauges ���� The simplest
insulin gauges are devices which allow the plunger on an insulin syringe to descend a set distance
and no more.� The
distance corresponds to a measured dose of insulin, and the gauge enables that dose to be reliably duplicated without sight.� To draw a different dose, you must use a different gauge.� You may need quite a collection!� Gauges
may be of a number of shapes (flat, corner molding, tube ...), and can be constructed of
many different materials (wood, plastic, metal, old credit cards...), but most of them will be rigid, flat, several inches square, and on one end of the gauge there will
be an L shaped notch.� This
L notch will fit on the plastic collar located between the flanges and the plunger of the
insulin syringe. ���� Further
down the insulin gauge will be the small slot where the plunger seats, once you have reached the
correct dose for that particular gauge.� When making an insulin gauge, keep the slot very narrow, to insure that when
the plunger is seated in the slot there is no play (which
would allow a variation in the dose).� The L notch and the slot must both be on the same side of the insulin gauge. � ���� The best
insulin gauges are those most durable. Insulin gauges constructed from cardboard or staples, however inexpensive, are NOT RECOMMENDED.� They distort and break too easily.�
The use of nonstandard or homemade insulin measuring devices should only follow a thorough checkout of such devices. ���� It is important
to understand that insulin gauges are "cut" for a specific brand and size of syringe.�
Therefore, an insulin gauge that has been cut for a Monoject,
Terumo, or other type syringe cannot be used, will not produce
an accurate reading, on a B D syringe and vice versa.�
An insulin gauge cut for a 1cc B D syringe cannot be successfully used on the 1/2cc (Lo Dose) or 30 unit
B D syringe, for the same reason. �������������������
Other Alternatives Appliances and Holders ���� The Insulcap,
a color coded, tactile cue equipped plastic fitting, attaches to an insulin vial and guides insertion of the syringe, holding the needle at the
correct depth.� The
syringe won't shift and bend the needle, as the Insulcap holds the bottle to the syringe, freeing both
hands for the filling operation.� Manufactured by Palco, sold by Diabetic Promotions, Inc., of Cleveland, OH; telephone:
1 800 338 4656, the Insulcap is sold in sets of two:�
one blue, without tactile cues; and one orange; with tactile cues. �Cost:� $6.95.� Individuals with low vision, arthritis, or other conditions causing unsteadiness,
may benefit, though those without sight would be better
served by devices such as the Count‑A‑Dose. ���� The Ident‑A‑Cap,
similar to the above, offers a selection of color coded and tactile cues.� Each package includes two different vial caps, which also attach
to the neck of the vial, providing some nonvisual identification
of the contents.� (There
are six choices when you order, they will send you the right caps.)� Until tactile marked insulin vials become widely available, this product may be
of benefit.� Cost:�
$1.99 for a package of two.�
Available from Diabetic Promotions; telephone: 1 800 433 1477, or
from Terron, Inc., P.O. Box 958, Sanger, TX 76266; telephone: 1 800 862 2348. ���� The Uni‑Cal‑Aid
allows tactile draw up of preset insulin doses, incorporates two adjustable preset stoppers, allowing two different doses or insulin mixing (resetting the doses requires sighted aid).� It accepts all syringe types, but any adjustment of dose requires sighted
aid. Cost:� $26,
available from:� The
Eye Dea Shop, Cleveland Sight Center, 1909 E. 101‑st Street, Cleveland,
OH 44106 8696; telephone:� (216) 791 8118, ext. 278. Pen Injection Devices ���� The Novolin
Pens:� Novo Nordisk
Pharmaceuticals Inc., 100 Overlook Center, Suite 200, Princeton, NJ 08540; telephone:� 1
800 727 6500, currently produces two pen type devices.� They
offer the "Novo Pen 3,"�
which retails at $29 (excluding insulin cartridge), and uses 300 unit "Novolin System" insulin cartridges (R, N, or 70/30 mix)
and "Novofine 30" disposable replacement needles.�
This device delivers a measured dose of between one and 70 units,
in one unit increments.� Novo Nordisk also offers "Novolin Prefilled" disposable syringes.� These devices are smaller than a pen injector, hold 150 units of R, N, or 70/30
mix insulin, and are packed five syringes to a package.
Suggested retail price (package of five syringes):�
$25.00; comparable to the cost of cartridge replacements for
the Novolin Pen. ���� Novo Nordisk
also offers insulin cartridges for the older� "Novo
Pen 1.5"� insulin
pens, and for other pens licensed to use their system. � ���� According
to the manufacturer of the Novo Nordisk pens and the prefilled Novolin syringes:� "None of our devices are recommended for use by blind or visually impaired persons without sighted aid." ���� The Autopen
is a British made insulin pen injector, designed to use either the Novolin system cartridges
and disposable needles or those made by Eli Lilly and Company.
In the U.S., marketer is Owen Mumford, Inc., 849 Pickens Industrial Drive, Suite 12, Marietta, GA 30062; telephone:
1 800 421 6936.� The
Autopen is available in two versions: a one unit increment (administers up to 16 units) and
two unit increment (up to 32 units) pen, differentiated only
by color.� Each
pen features audible clicks for each increment drawn.� Cost:�
$40 each. ���� Becton
Dickinson Corporation (in partnership with Eli Lilly and Company) offers the B D Pen.� Similar to the Novo Nordisk and Mumford pens, the system dispenses 150
units of R, N, Humalog, or 70/30 insulin, in one unit increments, from one to 30 units.� Although B D does not specify a "suggested list price," the pen should cost
about $40.� B D also offers a "pen magnifier" (similar to
the syringe magnifiers described below) that clips to the pen to
aid low vision operation.� This magnifier is available free of charge, by calling Becton Dickinson at:� 1 800 237 4554. Available at most pharmacies. ���� Eli Lilly
and Company (Lilly Corporate Center, Indianapolis, IN 46285; telephone:� 1 888 885 4559 (website: http://www.humulinpen.com)� offers the Humulin and Humalog pens, and the new Humalog 75/25 pen.� These are disposable prefilled syringe devices, holding 300 units of Lilly's Humulin 70/30, Humulin N, Humalog, or Humalog 75/25
insulin. These pens (which require detachable pen needles such
as the Becton Dickinson Insulin Pen Needles, sold separately) adjust in single unit increments, with an audible click
for each unit.� They
have a clear plastic barrel, and a magnifying dose window to help show the correct dose.
Suggested retail price:� $40 (package of five pens). ���� The Disetronic
Pen is a very different device, with an "open system" 315 unit cartridge that the
user fills with any prescribed insulin.� This pen does not use specialized needles, but rather any conventional syringe needle
(27 through 30‑gauge recommended).� The company claims the load it yourself feature makes it cheaper to use in
the long run.� Cost:�
$95.� Available from:� Disetronic Medical Systems, 5201 E. River Road, Suite 312, Minneapolis,
MN 55421 1014; telephone: 1 800 280 7801; website: http://www.disetronic usa.com Syringe Magnifiers ���� The Insul‑Eze
6000, manufactured by Palco Labs (listed above) is a syringe and vial holder incorporating a full length 2x lens, allowing the insulin drawing operation to be closely monitored. Insulin vials can be changed
for mixing without disturbing the syringe.� Adaptable, the Insul‑Eze works with most types of syringes in
the 30 , 50 , and 100 unit size.�
Cost:� $11. ���� The Truhand,
a device similar to the Insul Eze, is offered by� Whittier
Medical, Inc., 865 Turnpike Street, North Andover, MA 01845; telephone:� 1 800 645 1115.� It allows use of different syringe types and sizes, and
firmly holds the vial, while providing a 3x magnified view
of the scale.� Vials
can be changed for mixing without disturbing the syringe.� Cost:�
$29.95. ���� ���� The Magniguide,
offered by Becton Dickinson Consumer Products, One Becton Drive, Franklin Lakes, NJ 07417
1883; telephone:� 1
800 237 4554, is another syringe magnifier. It attaches to the insulin vial, and provides 2.5x magnification, to aid needle insertion, precise dose measurement, and location of bubbles in the syringe.�
The Magniguide is available (Cost:� $3.95) from Independent Living Aids, Inc., 27 East Mall, Plainview, NJ 11803
4404; telephone:� 1
800 537 2118. ���� The Syringe
Magnifier fits all 1/2cc and 1cc syringes, and clips to the syringe barrel, magnifying the scale
2x to aid precise dose measurement.� Manufactured by:� Apothecary Products, Inc., 11750 12‑th Ave. South, Burnsville,
MN 55337; telephone:�
1 800 328 2742.� The
device does not affect needle insertion, which must be done visually.�
Cost: $3.95. ���� The Diabetes
Action Network of the National Federation of the Blind is a support and information network for
all diabetics.� We
have many members willing to share their expertise in nonsighted techniques of diabetes self management.� If
you have any questions about diabetes and/or blindness, feel free to contact us. |
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