ForumDosing & Titration

Pen accuracy/dosing help?

8 replies3 peopleNov 19, 2025☆ Follow
Summary

why do some injection pens underdose on the very first use but then deliver accurate doses afterward

Users testing multiple pens found consistent underdosing on the initial dose even after priming, while later doses at the same or different settings matched the dialed amount exactly. The pattern held across generic and brand pens plus different cartridges when two people repeated the syringe-check method. Everyone observed the same first-use shortfall but no one identified a mechanical cause.

What this discussion establishesStill open

why the plunger travel is inaccurate only on the first actuation

Nothing here is advice.

8 replies · 3 people
ClearWillow47archiveopening postNov 19, 2025

Would someone be able to help me figure out what's happening here? I got some pens and decided to check their accuracy by sticking an insulin syringe into the pen, dialing up units, pressing the plunger, and seeing if the syringe reading matches what I set. The odd thing is it underdoses the first time every time, yet later tries are exact even at just 2 units. Steps I followed: put the cartridge in, attach the pen needle and keep dialing until the plunger touches the stopper and liquid starts coming out, set to 2 units, flick like a brand pen to clear air, push and confirm the 2 units came out so everything should be ready, remove the needle, insert the insulin syringe, dial 20 or 60 or 80 units while holding everything steady, and press. It underdoses. Then pull the syringe out and squirt the liquid away.

IronWillow10archiveNov 19, 2025

Are all your pens the same model or do you also have any brand-name ones? Not blaming the versions but they likely lack the tight manufacturing tolerances of a brand-name model. I still haven't checked my own pens for accuracy since I hate the thought of wasting a cartridge just to test. Maybe I should pick up some inexpensive ones elsewhere to run trials.

ClearWillow47archiveNov 19, 2025
↳ replying to @IronWillow10

I have four of the generic pens and one brand Luxura. The Luxura was giving inconsistent doses which is why I got the others. I can't see why dosing would be off only on the very first use of a pen. I'm using insulin syringes with fixed needles that have almost no dead space, so the needle itself isn't the problem or later doses wouldn't read correct. I also did all the priming steps to remove air beforehand.

ClearWillow47archiveNov 19, 2025
↳ replying to @AmberMarble84

Just a generic pen. So the only idea I have is that the plunger travel over a certain distance is off at the start but becomes accurate after that point. It's odd behavior because you'd think any error would show up later too.

AmberMarble84archiveNov 19, 2025

Could be, I don't know. I have the original brand pens and they did something similar a few times, though not at the start of a cartridge. I never figured out why, I could just see the plunger not moving on a large dose.

ClearWillow47archiveNov 19, 2025

Update! I checked all four generic pens plus the brand one, using both an official cartridge and another cartridge. I had a friend repeat the test to rule out my own technique and the underdosing on the first dose still showed up every time. Very weird.

AmberMarble84archiveNov 19, 2025
↳ replying to @ClearWillow47

that is a mystery ! just discard first dose then?

ClearWillow47archiveNov 19, 2025
↳ replying to @AmberMarble84

I could, but I think I'm onto something others may not have noticed yet. I'm wondering if this is actually happening to everyone and they just haven't caught it. It seems suspicious that two different people get the same result, two different cartridge sources, and two completely different pen makers all show it. All the usual ways to rule out user error and it still happens every time.

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