How much is 1 unit in ml

I am helping this couple with their diabetic cat and they gave 1 unit levemir this morning for the second time and the cat dropped from 252 to 52 in 6 hours, så obviesly the dose is to big. They are giving the cat the 1 unit in a levemir pen, but since they have to give less, they need to use a syringe instead. She has this one at home http://www.diashop.de/product1083/product_info.html it is very small, don't know if it is any good? But how much is one unit in this one?

 

Here's the picture from that web site:



It is a 1 ml, or 100 unit, insulin syringe.

Here's a bigger picture for easier reading:



Unfortunately, you cannot measure 1 unit on such an insulin syringe. The markings on the 1ml syringe are for every 2 units. You could try to eyeball between teh zero line and the 2 unit line to get 1 unit but it won't be exact.

Can your neighbor get 1/2 cc (aka 0.5 ml aka 50 unit) insulin syringes instead? Like these: http://www.diashop.de/category14_20/product570/product_info.html

The markings look like this and are for every single unit:



Better yet would be 3/10 cc (aka 0.3 ml aka 30 unit) insulin syringes. These are marked in every single unit. Some are even marked in every half unit.

 

Are you sure the markings are for every 2 units, from what i can count there are 10 small lines between the big lines?

 

10 lines between the marked units? Then you have what in the US is called a tuberculin syringe which are not suitable for giving insulin. Maybe Europe is different, though. In the US, a 1 ml insulin syringe has markings for every 2 units.

I couldn't get a picture to be inserted directly in this post so click on this link to see to where 1 unit is: https://lh4.googleusercontent.com/-...AAACeE/GZz70UyhpqE/s912/IMG_1655%2520edit.jpg

Every line in such a syringe is for every 0.01 ml: 0, 0.01, 0.02. 0.03, etc then the boldly marked 0.1, 0.11, 0.12, etc all the way up to 1.0 ml.

 

Yes it is saying tuberculin on the wrapping.Why is it not suitabel?

 

ok from your link i can see that getting 0,5 unit would be pretty much impossible.

 

A tuberculin syringes holds 1ml filled to the maximum. If you are using U-100 insulin, then
if you fill the TB syringe to the maximum, that is 100 units of insulin (100 units of insulin per ml of liquid
volume).

On some TB syringes I have, the first numbered mark is "0.1"....that' s 1/10th of a ml. And 0.1 ml of
U-100 insulin is 10 (ten) units of insulin.

I"M ASSUMING YOU ARE USING U-100 INSULIN !!!!! (If U-40 or U-50, these calculations will be different).

To get ONE unit of insulin in a TB syringe, remember that the very first mark next to the needle is "zero", then
each tiny little line is 0.01 ml or one unit of insulin, up to the first numbered mark (0.1ml), which is ten units of insulin.

It will be almost impossible to measure 1/2 unit of insulin in a TB syringe. You really need to get some insulin syringes.

The best for U-100 insulin are 3/10 cc capacity, 30 or 31 gauge, with 1/2-unit marks. Be sure to look at the
box of syringes for the words "1/2-unit marks" or something similar. Some pharmacists will insist that no such
thing exists, and will try to sell you syringes with 1/2cc capacity, instead. They are NOT the same thing.

 

Thanks you both. It is not for me since Prop is in remission, but it is for this couple I help. They are using levemir in a pen. Levemir is U100. But since the cat dropped so much on 1 unit, now at +9 he is at 65 they would need to lower the dose and wont be able to get syringes until monday. But we have talked about shooting the 1 unit out on a dish and the eyeball just a little bit until monday and then watch bg closely.

 

Or maybe skip a dose. I'm not sure if using the dish would be easy.

 

Is it possible to get 3/10 ml syringes? That is what many of us use. And some of these the 1/2 unit markings --- so 10 marks between 0 and 5 U

This makes it easier to make tiny doses.

My cat Tiggy only needs 0.5u BID.

 

Here is the response I got in 2009 from BD about using tuberculin or allergy syringes:


Thank you for contacting BD regarding the use of allergy syringes for the administration of insulin. We cannot nor would we recommend allergy syringes for the purposes of administering insulin. There are several reasons:

1. While the graduations are equivalent on the one side of the two syringes ( listed in 0.1mL's). Insulin syringes are also graduated in units and are scaled to match U-100 insulin concentration
2. Insulin has the highest medication error rate of all medications. These are typically calculation errors usually a ten fold increase in the amount due to a simple decimal place movement. But can have significant effect and negative medical outcome. The use of milliliters versus the unit scale could cause this type of conversion math error. Example: 10 units is suppose to be 0.1mL's but if miscalculated could be interpreted as 1mL or now 100 units. Basically 10X error.
3. The needle gauge on an allergy syringe is typically slightly larger than the traditional insulin syringes preferred today. Typically an allergy syringe is 27 gauge. Compare that to our more frequently demanded insulin syringe patients are looking for 29 gauge or even 31 gauge. A considerable improvement in comfort perception.
4. Last but not least. As a rule of thumb depending upon the number of units you are administering it is always advisable to use the smallest possible syringe. If administering 20 units use a 30 (3/10mL) insulin syringe, if 40 units use a 50 unit or 1/2mL insulin syringe. Allergy syringes only go to 1/2mL size.

Posted at http://www.felinediabetes.com/phorum5/read.php?8,1839069

Yes, you cannot easily or accurately measure less than 1 unit on those syringes. Can the couple you are helping get some proper insulin syringes? They need to get the 0.3 ml ones. Not sure if half unit marked insulin syringes are available in Europe? If not, you can just eyeball between the units to get the half unit. Use the pictures here for help: http://steverapaport.com/jock/SyringeFineGradations/