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ForumsMarketplace & ListingsInsulin syringe sourcing — anyone have experience?

Insulin syringe sourcing — anyone have experience?

tammy_FL Fri, Oct 18, 2024 at 1:04 PM 37 replies 2,114 viewsPage 1 of 8
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tammy_FL
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Oct 18, 2024 at 1:04 PM#1

Posting this because the summary going around does not say what the paper says, and the difference matters for how people here are using it.

Dead space is the answer to the missing dose. A fixed-needle insulin syringe holds a few microlitres in the hub and needle after the plunger bottoms out, and on small draws that is a measurable percentage of every dose. Across ten draws it adds up to most of an eleventh, which is exactly the "nine draws from a ten-dose vial" complaint. Luer-lock syringes are worse; low-dead-space fixed-needle designs are better.

Where I think it is weakest: the completion rate deserves as much attention as the headline, because a large effect among those who finished is a different claim from a large effect among those enrolled.

The narrow version of the question is how much material I am losing to dead space, and whether that explains why a 10mg vial gives me nine usable draws rather than ten. Practical detail welcome, however dull — the duller the better.

Note on sourcing:
Figures above are from the primary publication rather than the press summary. If a number here disagrees with one you have, post yours and we will work out which of us is reading a secondary source.
36 6Dr.LipidDallas, alex_tucson, kevin_tulsa and 33 others
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KevinCompounds
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Oct 18, 2024 at 1:19 PM#2
tammy_FL said:
Dead space is the answer to the missing dose.

tammy_FL has the substance of this right. The condition it depends on is worth stating. Do it in two steps and it stops being confusing. First concentration: 10mg into 2ml is 5mg/ml. Then volume: a 0.5mg dose is 0.5 ÷ 5 = 0.1ml. Then units, and this is where people go wrong — a U-100 syringe is graduated in hundredths of a millilitre, so 0.1ml is 10 units. The word "units" has nothing to do with milligrams; it is a volume marking that exists because insulin happens to come at 100 units per ml.

Correct me if the detail matters more than I have assumed.

Last edited: Oct 18, 2024 at 3:19 PM
35 5Dr.RaviCardio, jennifer_SEA, tyler_CSCS and 32 others
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VendorMark
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Oct 18, 2024 at 1:34 PM#3
tammy_FL said:
Dead space is the answer to the missing dose.

I am going to disagree with reconstituting low as a general rule. More diluent, more punctures, more in-use days at room temperature, and the stability trade-off is real. Precision is not the only variable being optimised.

34 4MarkLI_maint, Dr.PeteFamMed, claudia_zurich and 31 others
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LibrarianMeg
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Oct 18, 2024 at 1:49 PM#4

Answering the narrow version, because the broad one does not have a single answer. Concentration choice is a precision decision, not a preference. Reconstitute high and every dose is a tiny volume where one unit of syringe error is a large fraction of the dose. Reconstitute low and you get more graduations per dose, so the same hand tremor costs proportionally less. Against that, more diluent means more benzyl alcohol and a shorter comfortable in-use window.

Last edited: Oct 18, 2024 at 3:49 PM
33 3JessicaM_2024, TomFromTexas, mike.trainer_LA and 30 others
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GraceAZ_72
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Oct 18, 2024 at 3:09 PM#5
KevinCompounds said:
Do it in two steps and it stops being confusing.

Agreed, with a caveat about community reputation: it is a lagging indicator. Reports arrive weeks after orders, so a supplier can look excellent for a month after quality has already changed.

32 2RetaRick_CA, JenPlateau, SallyK_inj and 29 others
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