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Can I Use A Frozen Lantus?

How Long Should Insulin Be Used Once A Vial Is Started?

How Long Should Insulin Be Used Once A Vial Is Started?

Editor’s comment: The commentary by Dr. Grajower has such important clinical relevance that responses were invited from the three pharmaceutical companies that supply insulin in the U.S. and the American Diabetes Association, and all of these combined in this commentary. The commenting letter and individual responses were authored separately and are completely independent of each other. Diabetic patients treated with insulin, whether for type 1 or type 2 diabetes, are prone to often unexplained swings in their blood glucose. These swings can vary from dangerously low to persistently high levels. Most diabetic patients, and most physicians, will adjust insulin regimens so as to avoid hypoglycemia at the expense of hyperglycemia. Among the “textbook” reasons for variable glucose responses to any given insulin regimen are 1) site of administration, 2) exercise, 3) bottles not adequately mixed before drawing the insulin (for NPH, Lente, or Ultralente), and 4) duration of treatment with insulin (1). A new insulin was marketed by Aventis Pharmaceuticals about 1 year ago, insulin glargine (Lantus). The manufacturer seemed to stress that patients not use a started bottle of this insulin for >28 days (2). Two patients of mine highlighted this point. L.K. is a 76-year-old woman with type 2 diabetes, diagnosed at 55 years of age, and treated with insulin since age 56. Her insulin regimen was changed to Lantus at night together with Novolog before meals. She monitors her blood glucose four times a day. She used a bottle of Lantus until it ran out; therefore, a bottle lasted for 2 months. Her recent HbA1c was 7.6%. I retrospectively analyzed her home glucose readings by averaging her fasting blood glucose levels for the first 15 days of a new bottle and the last 15 days of tha Continue reading >>

Is It Safe To Take Insulin That Has Frozen?

Is It Safe To Take Insulin That Has Frozen?

Now playing: Is it safe to take insulin that has frozen? Photographs are being used for illustrative purposes only. The people depicted in the licensed material are models. Important! Information presented is not a substitue for professional medical advice. tell me more Insulin freezes almost as easily as water, and can be damaged by too much heat, so it's important to keep it protected from the elements. Once it's been opened, you can keep your insulin at room temperature for one month. Using insulin that's been frozen is dangerous, because if the protein has been damaged, it could mean you're not getting an adequate dose. Continue reading >>

How To Inject Lantus® With A Vial And Syringe

How To Inject Lantus® With A Vial And Syringe

Do not take Lantus® during episodes of low blood sugar or if you are allergic to insulin or any of the inactive ingredients in Lantus®. Do not share needles, insulin pens, or syringes with others. Do NOT reuse needles. Before starting Lantus®, tell your doctor about all your medical conditions, including if you have liver or kidney problems, if you are pregnant or planning to become pregnant or if you are breast-feeding or planning to breast-feed. Heart failure can occur if you are taking insulin together with certain medicines called TZDs (thiazolidinediones), even if you have never had heart failure or other heart problems. If you already have heart failure, it may get worse while you take TZDs with Lantus®. Your treatment with TZDs and Lantus® may need to be changed or stopped by your doctor if you have new or worsening heart failure. Tell your doctor if you have any new or worsening symptoms of heart failure, including: Sudden weight gain Tell your doctor about all the medications you take, including OTC medicines, vitamins, and supplements, including herbal supplements. Lantus® should be taken once a day at the same time every day. Test your blood sugar levels while using insulin, such as Lantus®. Do not make any changes to your dose or type of insulin without talking to your healthcare provider. Any change of insulin should be made cautiously and only under medical supervision. Do NOT dilute or mix Lantus® with any other insulin or solution. It will not work as intended and you may lose blood sugar control, which could be serious. Lantus® must only be used if the solution is clear and colorless with no particles visible. Always make sure you have the correct insulin before each injection. While using Lantus®, do not drive or operate heavy machinery until Continue reading >>

What Are The Possible Side Effects Of Insulin Glargine (lantus, Lantus Opticlik Cartridge, Lantus Solostar Pen)?

What Are The Possible Side Effects Of Insulin Glargine (lantus, Lantus Opticlik Cartridge, Lantus Solostar Pen)?

LANTUS® (insulin glargine) Injection DESCRIPTION LANTUS (insulin glargine injection) is a sterile solution of insulin glargine for subcutaneous use. Insulin glargine is a recombinant human insulin analog that is a long-acting, parenteral blood-glucose-lowering agent [see CLINICAL PHARMACOLOGY]. Insulin glargine has low aqueous solubility at neutral pH. At pH 4 insulin glargine is completely soluble. After injection into the subcutaneous tissue, the acidic solution is neutralized, leading to formation of microprecipitates from which small amounts of insulin glargine are slowly released, resulting in a relatively constant concentration/time profile over 24 hours with no pronounced peak. This profile allows oncedaily dosing as a basal insulin. LANTUS is produced by recombinant DNA technology utilizing a non-pathogenic laboratory strain of Escherichia coli (K12) as the production organism. Insulin glargine differs from human insulin in that the amino acid asparagine at position A21 is replaced by glycine and two arginines are added to the C-terminus of the B-chain. Chemically, insulin glargine is 21A-Gly-30Ba-L-Arg-3030b-L-Arg-human insulin and has the empirical formula C267H404N72O78S6 and a molecular weight of 6063. Insulin glargine has the following structural formula: LANTUS consists of insulin glargine dissolved in a clear aqueous fluid. Each milliliter of LANTUS (insulin glargine injection) contains 100 Units (3.6378 mg) insulin glargine. The 10 mL vial presentation contains the following inactive ingredients per mL: 30 mcg zinc, 2.7 mg m-cresol, 20 mg glycerol 85%, 20 mcg polysorbate 20, and water for injection. The 3 mL prefilled pen presentation contains the following inactive ingredients per mL: 30 mcg zinc, 2.7 mg m-cresol, 20 mg glycerol 85%, and water for inje Continue reading >>

Insulin Storage And Refrigeration

Insulin Storage And Refrigeration

I had an insulin-dependent type 2 patient who was on Solostar Pens of Glargine 65u hs and Apidra 18u tid plus sliding scale for glucose control. The patient got their insulin from a mail order pharmacy, 90 days supply at a time. The patient was in fairly good control with a prior A1c of 6.9 and an average fasting of 122mg/dl. I got a call from the patient’s husband on Friday evening at 5 pm because his wife had had a glucose reading of 245 mg/dl at 3:30pm after taking an Apidra dose of 21 units before lunch. He told me that she had taken another 14 units at 2 pm and now at 5 pm the glucose was up to 319 mg/dl…. My first thought was that there was something wrong with the insulin because the bottle was almost empty so I instructed them to get a new vial of Apidra and try dosing 7 units then call me back in 2 hours. At 7:30 pm I got a call and the patient was at 325 mg/dl and was in a panic. I had them go to the refrigerator and grab all the vials of Apidra. The patient came back to the phone with 6 unopened boxes of insulin. I had them check the expiration dates, which were all good and then I had them open each box. After the third box was opened I knew the reason for the glucose problems. There were ice crystals in the bottle because the insulin had been frozen. Whenever insulin freezes there is a possibility that it will no longer be effective. I found out from the patient that some of the bottles had got pushed to the far back corner of the fridge and must have frozen. I called a 24-hour pharmacy with a new prescription for the Apidra and the patient’s glucose was back under control by midnight. Lesson Learned For this particular patient the storage spot of insulin in the refrigerator caused the insulin to freeze but when the patient got the single new box out Continue reading >>

Insulin Accidently Frozen.

Insulin Accidently Frozen.

Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community My fridge freezer went on the bling end of oct. The main concern was it was freezing food in the fridge as well as freezer. We tried to do some troubleshooting and actually left it to go away for a week. On return the food we'd left had spoiled.Solid frozen eggs, frozen apples and of course my insulin. It didnt look totally frozen solid but it then was taken out and put back in two days later when we purchased a new fridge. This was all about first week in Nov. Now I'm having a job controlling my blood sugars. It's just ocurred to me I may have damaged my insulin which is now useless. I've been getting depressed thinking my diabetes was getin out of control. I take Lantus at night and have been increasing this slowly but not much happening. Same with Apidra during the day. It doesn't seem terribly effective any more. Do I dump this batch and get new batch. I do hate waste!! Continue reading >>

Lantus

Lantus

NOTICE: This Consumer Medicine Information (CMI) is intended for persons living in Australia. (lant-us) What is in this leaflet It does not contain all the available information. It does not take the place of talking to your doctor, pharmacist or diabetes educator. All medicines have risks and benefits. Your doctor has weighed the risks of you using Lantus against the benefits they expect it will have for you. If you have any concerns about using this medicine, ask your doctor or pharmacist. What Lantus is used for Lantus is used to reduce high blood sugar (glucose) levels in people with diabetes mellitus. Lantus is a modified insulin that is very similar to human insulin. It is a substitute for the insulin produced by the pancreas. Lantus is a long-acting insulin. Your doctor may tell you to use a rapid-acting human insulin or oral diabetes medication in combination with Lantus. Ask your doctor if you have any questions about why Lantus has been prescribed for you. Before you use Lantus When you must not use Lantus Some of the symptoms of an allergic reaction may include: If you have a lot of hypos discuss appropriate treatment with your doctor. After the expiry date printed on the pack or if the packaging is torn or shows signs of tampering. If you use Lantus after the expiry date has passed, it may not work as well. If it has expired or is damaged, return it to your pharmacist for disposal. If the product appears cloudy, discoloured or contains particles, or if the injection pen/cartridge/vial appears damaged. If you are not sure whether you should start using this medicine, talk to your doctor. There is no experience with the use of Lantus in children less than 6 years. Before you start to use Lantus Tell your doctor if you have allergies to any other medicines, foo Continue reading >>

Insulin Glargine - Health Library | South Dayton Urological - Kettering, Springboro, Oh - Sacrocolpopexy - Prostatectomy - Kidney - Da Vinci Surgical System

Insulin Glargine - Health Library | South Dayton Urological - Kettering, Springboro, Oh - Sacrocolpopexy - Prostatectomy - Kidney - Da Vinci Surgical System

Brand: Basaglar KwikPen, Lantus, Lantus Solostar Pen, Toujeo SoloStar What is the most important information I should know about insulin glargine? Never share an injection pen or syringe with another person, even if the needle has been changed. Insulin is a hormone that works by lowering levels of glucose (sugar) in the blood. Insulin glargine is a long-acting insulin that starts to work several hours after injection and keeps working evenly for 24 hours. Insulin glargine is used to improve blood sugar control in adults and children with diabetes mellitus. Insulin glargine is used to treat type 1 or type 2 diabetes in adults, and type 1 diabetes children who are at least 6 years old. Some brands of this medicine are for use only in adults. Carefully follow all instructions for the brand of insulin glargine you are using. Insulin glargine may also be used for purposes not listed in this medication guide. What should I discuss with my healthcare provider before using insulin glargine? You should not use this medicine if you are allergic to insulin, or if you are having an episode of hypoglycemia (low blood sugar). Insulin glargine is not approved for use by anyone younger than 6 years old, and should not be used to treat type 2 diabetes in a child of any age. To make sure insulin glargine is safe for you, tell your doctor if you have: low levels of potassium in your blood (hypokalemia); or diabetic ketoacidosis (call your doctor for treatment). Tell your doctor if you also take pioglitazone or rosiglitazone (sometimes contained in combinations with glimepiride or metformin). Taking certain oral diabetes medicines while you are using insulin may increase your risk of serious heart problems. Follow your doctor's instructions about using insulin if you are pregnant or breas Continue reading >>

5 Insulin Mistakes You Need To Avoid

5 Insulin Mistakes You Need To Avoid

If you use insulin to keep your blood sugar in check, these five common mistakes could lead to dangerous lows or highs. What you need to know: 1. Wrong dose, wrong insulin. There are four basic types of insulin: Rapid- and short-acting insulins are injected before a meal to cover the rise in blood sugar from the food you’re about to eat; intermediate- and long-acting insulins control blood sugar for up to 24 hours, covering periods of time when shorter-acting types have stopped working. People with type 1 diabetes often take a combination of shorter-and longer-acting insulins – and that’s where mix-ups can happen. Among the most common: Taking a too-high dose of a rapid-acting insulin because you’ve mistaken it for a longer-acting type, according to a report in the journal Clinical Diabetes. The danger: Low blood sugar. The fix: If this happens to you, eat enough carbohydrates to cover the extra insulin, keep monitoring your blood sugar, watch for signs of hypoglycemia (such as shaking, sweating or a headache ) and call your doctor right away if you have any concerns. To prevent it from happening again, make sure you know which insulin is which and what the right dose is. In a 2014 report in the journal Prescrire International, experts note that sometimes, doctors and pharmacies abbreviate the word “units” to “U”, which can look like an extra zero, leading people to take insulin doses ten times higher than prescribed. Ask your doctor or pharmacist if you’re unsure of the right dose. 2. Sharing an insulin pen. Insulin pens are a convenient way to get a just-right dose without filling and injecting yourself with a conventional syringe. They can be used multiple times, with a new needle each time. But a fresh needle doesn’t mean sharing’s OK. The Cent Continue reading >>

Insulin Basics | Diabetesnet.com

Insulin Basics | Diabetesnet.com

Thu, 11/18/2010 - 15:14 -- Richard Morris Store insulin you are not using in a refrigerator. It is a protein dissolved in water, sort of like a soup stock, so keep it cold to prevent it from spoiling. Keep it between 36º and 46º F. If it gets colder it will freeze. If the insulin freezes, when it thaws it will separate and clump and will no longer be usable. If it gets warmer it will be ok for awhile but will eventually spoil. If it starts to spoil, bacteria growing in it breaks down the insulin. It won't hurt you to use this. However, its not as effective so your blood sugar will be higher than you expect even though you took the right amount of insulin at the right time. It is ok to keep a bottle of insulin you are using at room temperature for up to 28 days (room temperature is 59º to 86º F). The preservative in insulin keeps it from spoiling this long. Insulin at room temperature injected into the skin is more comfortable for many people. Also, it may be easier to get rid of air bubbles in the syringe when it is at room temperature. If you live in a hot climate and your room temperature is above 80º, keep your insulin in the refrigerator. Insulin in a pen can only be kept at room temperature for 2 weeks before it begins to spoil. Check with your pharmacist, the package insert or the manufacturer's websites. Insulin used past 28 days at room temperature or past the expiration date on the box may still be good. However, using it may cause control problems and is not recommended. Lantus, Humalog and Novolog seem to spoil faster than Regular and NPH. If you can't afford to buy insulin and insurance does not cover it, you may be able to get it free. Check the website www.helpingpatients.org or call 202-835-3400. The doctor who prescribes your insulin can help you g Continue reading >>

Information Regarding Insulin Storage And Switching Between Products In An Emergency

Information Regarding Insulin Storage And Switching Between Products In An Emergency

en Español Insulin Storage and Effectiveness Insulin for Injection Insulin from various manufacturers is often made available to patients in an emergency and may be different from a patient's usual insulin. After a disaster, patients in the affected area may not have access to refrigeration. According to the product labels from all three U.S. insulin manufacturers, it is recommended that insulin be stored in a refrigerator at approximately 36°F to 46°F. Unopened and stored in this manner, these products maintain potency until the expiration date on the package. Insulin products contained in vials or cartridges supplied by the manufacturers (opened or unopened) may be left unrefrigerated at a temperature between 59°F and 86°F for up to 28 days and continue to work. However, an insulin product that has been altered for the purpose of dilution or by removal from the manufacturer’s original vial should be discarded within two weeks. Note: Insulin loses some effectiveness when exposed to extreme temperatures. The longer the exposure to extreme temperatures, the less effective the insulin becomes. This can result in loss of blood glucose control over time. Under emergency conditions, you might still need to use insulin that has been stored above 86°F. You should try to keep insulin as cool as possible. If you are using ice, avoid freezing the insulin. Do not use insulin that has been frozen. Keep insulin away from direct heat and out of direct sunlight. When properly stored insulin becomes available again, the insulin vials that have been exposed to these extreme conditions should be discarded and replaced as soon as possible. If patients or healthcare providers have specific questions about the suitability of their insulin, they may call the respective manufacturer a Continue reading >>

Ask D'mine: Insulin On The Rocks

Ask D'mine: Insulin On The Rocks

Got questions about navigating life with diabetes? Ask D'Mine! Our weekly advice column, that is — hosted by veteran type 1, diabetes author and educator Wil Dubois. This week, Wil experiments with his home freezer after getting a question about how cold insulin can get before it proves unusable. Read on: you might just get chills hearing what he discovered! {Got your own questions? Email us at [email protected]} Mary, type 1 from North Dakota, asks: Lots has been written about insulin and heat, but what about insulin and cold? How cold can insulin get and still be "OK?" I know we store it in the fridge, but can it freeze? Well, of course it can, but is it more like water, or more like anti-freeze? How cold does it need to get before it freezes solid? If it did get frozen, can you thaw it back out and still use it? [email protected] D'Mine answers: For the sake of science, I put the last dredges of a vial of NovoLog into my kitchen freezer last night. Now, there wasn't that much left, maybe only 20 units or so, but this morning I was rewarded with Novo-ice in my Novolog vial. How cold is my freezer? I have no idea. It's a garden-variety Kenmore. It will make ice cubes and turn Häagen-Dazs into a solid rock, while leaving my pecans soft enough to eat right out of the freezer. So it's pretty much just like every other freezer in the country. My son Rio chilled a glass of wine in the freezer for me this summer, but I got home late and the vino was about half frozen. On the other hand, we chilled some whiskey shots overnight with no whiskey-ice at all. So from all this comparative science, we can safely infer that the freezing point of insulin is much closer to that of water than it is to wine (typically 13.5% alcohol) or to whiskey (typically 40% alcohol). Therefore the Continue reading >>

5 Bottles Of Frozen Insulin And 72 Hours To Live - Part 2

5 Bottles Of Frozen Insulin And 72 Hours To Live - Part 2

Arriving in Dumaguete we noted the numerous pharmacies on the way to our hotel, checked in and proceeded to play hunt the Humalog in almost all pharmacies in town. Let me tell you a little about Dumaguete, the city of "gentle people"... (Part 1 - 5 bottles of frozen insulin and 72 hours to live) A little sinister The city had gotten popular for medical holidays, tourists would come on holiday for medical treatment in the Philippines as it was much cheaper than the same treatment / operation at home. Also we noticed a large number of middle age to very old American men with questionably young Philippine woman, this was comical at the start but quickly got disturbing, the slogan of the city had a sinister side. With all these medical tourists and old western locals had created a pharmacy boom in the small city. Every street had at least two pharmacies, so checking most of the pharmacies in town was no small job! Unfortunately all resulted in the same answer, no Humalog. You do have to question pharmacies that also sell cigarettes, have an attached hotel and provide advice that Lantus would be a better insulin for me. After the 20th person smiling at me and saying no we do not have your medication and "have a nice day sir" started to get me a little short tampered. In the UK I can guarantee I could walk into any pharmacy, explain my situation and get instant access to my medication, I know, i have done it. Not many countries you can do that, even so called super powers like America I would be surprised if you could do such a thing due to the limited interest in public healthcare, in the UK we really do not appreciate how lucky we are and how functional the NHS and it's supporting departments operate in supporting the nation. Why Humalog? With no Humalog in town, the local Continue reading >>

Basaglar (insulin Glargine) Dose, Indications, Adverse Effects, Interactions... From Pdr.net

Basaglar (insulin Glargine) Dose, Indications, Adverse Effects, Interactions... From Pdr.net

Hormone secreted by pancreatic beta-cells of the islets of Langerhans and essential for the metabolism and homeostasis of carbohydrate, fat, and protein. Insulin glargine is a once-daily basal insulin analog without pronounced peaks. BASAGLAR, Lantus, Lantus SoloStar, Toujeo SoloStar BASAGLAR/Lantus/Lantus SoloStar/Toujeo SoloStar Subcutaneous Inj Sol: 1mL, 100U, 300U For the treatment of type 1 diabetes mellitus and type 2 diabetes mellitus. For the treatment of type 1 diabetes mellitus. Subcutaneous dosage (100 units/mL, i.e., Lantus, Basaglar) Initially, administer one-third of the total daily insulin requirements/dose subcutaneously once daily. Titrate dosage to achieve blood glucose control and A1C goals in conjunction with a short-acting insulin. Give the dose at the same time every day, at any time. Administration in the morning may avoid nocturnal hypoglycemia. When transferring from once daily NPH insulin, the dose is usually not changed. However, when transferring from twice-daily NPH insulin to insulin glargine, the total daily dose of NPH insulin (or other twice daily basal insulin) should be reduced by 20% and administered as single dose once daily. When transferring from once-daily Toujeo to once-daily Lantus or Basaglar, the recommended initial Lantus or Basaglar dose is 80% of the Toujeo dose that is being discontinued. Thereafter, the dosage of insulin glargine should be adjusted to response. Children and Adolescents 6 years and older Insulin requirements are highly variable and must be individualized based on patient-specific factors and type of insulin regimen. During partial remission phase, total combined daily insulin requirement is often less than 0.5 units/kg/day. Prepubertal children (outside the partial remission phase) usually require 0.7 to Continue reading >>

Refrigerating Insulin, What If It Freezes?

Refrigerating Insulin, What If It Freezes?

Refrigerating insulin, what if it freezes? Registration is fast, simple and absolutely free so please,join our community todayto contribute and support the site. This topic is now archived and is closed to further replies. Refrigerating insulin, what if it freezes? The temperature here is around 34oCelsius, I am wondering if I should keep insulin in the fridge? I kept my lantus in the fridge (not the freezer, but the lower part)yesterday night just to be safe, but today morning I thought it became a little thicker in consistency. I turned it around to see if the air bubbles in it moved and they didn't, so I thought it had frozen. I primed a few units anyway and after some initial resistance, the insulin did come out. I primed a few more times just to be sure and then injected. Even if it has slightly frozen, can you just wait till it thaws and then inject? This is just what i have been told - there may be other stories out there - but for what it's worth... we are told to keep our insulin in the door of the refrigerator (i.e. away from the very cold part at the back) so that it doesn't freeze. Apparently, freezing can effect insulin, making it ineffective. I would suggest that if you are going to use it, that you keep an eye on your readings - if things seem to be going high, you may need to get new insulin. (One story from my endo: a woman was admitted to hospital here with DKA even though she had been injecting way above her normal insulin requirement. She happened to mention that the insulin box smelt 'fishy'. Turns out it had been transported with a load of fish, and got frozen somewhere along the delivery chain. Even though it was thawed out, it had lost whatever it was that made it work (I'm sure someone here can explain how that might be) and it was as if she ha Continue reading >>

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