Why Do Long and Short Acting Insulin Pens Look Nearly Identical?

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On the top Tresiba long-acting basal insulin, in the middle old Fiasp and on the bottom new Fiasp ultra-rapid insulin

Please Novo Nordisk, what are you thinking? Both your Tresiba and FIASP insulin pens are nearly identical. I know already I will at least once, if not more, grab the wrong pen and take seven times my mealtime dose accidentally.

For the first time ever, after 46 years with type 1 diabetes, I’m using Novo Nordisk’s insulins for both my basal and bolus: Tresiba and FIASP.

This is the picture I took this morning of my pens just after looking down at the Tresiba pen in my thigh as I had my finger on the plunger having just pressed it, thinking, “Oh, my god, is that my Tresiba in my leg or the FIASP? SH*T!!!” All I saw was a navy blue pen.

The caps look different because the Tresiba pen (on the bottom) has a Timesulin cap on it.

I switched to Tresiba and I’m experimenting with FIASP after being a long time user of Sanofi’s Lantus and Lilly’s Humalog. I’m very happy with both insulins. Tresiba covers me a full 24 hours plus, while Lantus only stretched to about 19 hours. And FIASP, which I’ve just started to see if it actually is faster than Humalog, appears to be. No complaints about the insulins. In fact, I’d recommend them easily.

But how could those at pharma companies, whose hands these pens flow through upon creation and sale – device designers, engineers, research and development, business development, marketing and strategy professionals – not consider the risk to patients of confusing these two pens? Untold numbers of people with diabetes will use both these products – just as the company would like them to.

How could one not notice that the identical color of the pens, design and shape will cause many customers to mix them up and result in potentially life-threatening consequences?

I’ve already done it, mixed up my short acting and long acting pens once with two pens from two different companies that were not identical.

Novo Nordisk is not alone, although I find the choice of navy blue for both pens egregious. Here are Sanofi’s Lantus (basal insulin) and Apidra (bolus insulin) pens. Also, far too similar. In “real life” the color difference is not as pronounced; they both share a blue/grey hue. (Here’s a story about mixing up Sanofi’s almost identical insulin pens. The story was written in 2010, and all these years later, we still have look-alike pens.) 

Sanofi.jpegLuckily, this morning the correct pen was in my leg. But trust me, in the middle of making breakfast and picking up a pen to take one of my six or so shots a day, the day will come when I take seven units of FIASP (my Tresiba dose) when I meant to take one. Am I to blame? Sure. But make it easier for us to avoid potentially life-threatening mistakes. Make insulin pens mistake-proof.

Why can we not have pens that are dramatically different colors, especially from the same company, different shapes, different texture or make a sound when you take off the cap. Users of insulin pens already take it upon themselves to distinguish their pens by putting duct tape or rubber bands around one pen, or keeping their pens in different rooms. It should not be so hard.

I’d like to see the company that embraces the hippocratic oath, “first do not harm” and reflects it in the pens they put in our hands.

You can do more, you can do better to help people with diabetes have one less thing to worry about – taking an insulin overdose – when they take their medication multiple times a day.

Originally posted on DiabetesStories.

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