Everything You Ever Wanted To Know About Injecting Insulin…
But Didn’t Know to Ask Just take your shot. What could be easier, right? Well, you’d be surprised how many errors are made by “veteran” insulin users. It turns out there’s nothing basic about the basics of insulin injections. However, you can improve your technique. This article takes a look at the nitty-gritty details behind successful insulin delivery, why they matter, and how to avoid common pitfalls. The gear Realistically, there are two delivery systems when it comes to injecting insulin: syringes and pens. Yes, there are pumps, but that’s a whole other subject. And yes, there are jet injectors, but they are not widely used. Syringes. The first-ever human insulin shot was delivered by syringe in 1922, and here in the United States, more than half of all insulin is still delivered via syringe. Syringes used to be made of glass, had to be sterilized between uses, and had long, thick, steel surgical needles that could be resharpened on a kitchen whetstone. (No kidding.) But syringes have come a long way since then. Syringes are now disposable, the barrels are made of plastic, and the needles are thin, high-tech, multi-beveled, and coated with lubricants to make them enter the skin smoothly. (Bevels are the slanted surfaces on a needle that create a sharp point.) In the old days, the needle and the syringe were separate components. Nowadays most insulin syringes come with the needle attached. People who use syringes almost always purchase insulin in vials. Vials are glass bottles that generally hold 1,000 units of insulin. Pens. Insulin pens date from the mid-1980s, and while syringes still predominate in the United States, much of the rest of the world has traded in syringes for insulin pens. Pens currently come in two varieties: disposable, prefilled pens Continue reading >>
Tweet Insulin pens are common in the United Kingdom, and are generally characterised by a different shape and the fact that they use an insulin cartridge as opposed to a vial. Some insulin pens use replaceable cartridges, and others use non-replaceable cartridges and must be disposed of after being used. Most insulin pens use replaceable insulin pen needles, which have become extremely short and thin. The replaceable cartridges for insulin pens come in 3 and 1 ½ ml sizes, although 3 is more common and has become dominant. Prefilled insulin pens are disposed of when the insulin within the cartridge is used up. Prefilled pens are often marketed for type 2 diabetics who need to use insulin. Insulin Pens Browse through our list of insulin pen reviews. You can also buy the insulin pens from the Diabetes Shop. Simply click on an insulin pen name to read the guide. How do I use an insulin pen to treat my diabetes? Using a pen is a relatively easy process. Some pens require gentle shaking before use. Once the cartridge is loaded, screw on a needle and prime the pen to clear air. Then dial in the exact dose that you require to deliver the insulin to the body. What is good about insulin pens as opposed to syringes? Insulin pens are very easy to use. They are great for young diabetics who need to deliver insulin at school. Furthermore, many diabetics find insulin pens almost painless. They are also portable and discreet, as well as not being as time-consuming as syringes. An accurate dose can be pre-set on the dosage dial, which can be useful for diabetes sufferers who also have impaired vision. Why might I not like insulin pens? Insulin pens are not right for 100% of diabetes patients. Insulin in pens and cartridges is generally more expensive than bottled insulin and syringes. Continue reading >>
How Long Should You Keep Insulin Pens?
Did you read our blog on insulin vials and think to yourself, does this apply to my insulin pens too? If so, this post is for you! With so many different insulin and insulin-like products out there these days it can be hard keep track of how long each of these pens stays good. Depending on your dose, you may still have insulin left in your pen at the manufacturer-recommended time to throw it away. If this sounds like a familiar situation, know that it is important to throw away your pen regardless of whether you have any leftover. You might think it’s wasteful, but using the medication past the recommended time can actually do you more harm than good. You may notice if you continue to use insulin from a pen that’s past the manufacturers discard date, your blood glucose may be higher or a greater dose may be needed to achieve a normal blood glucose reading. There are several different types of insulin and a variety of other injectable diabetes medications, and they don’t all have the same recommendations. As a quick reminder, the different categories of insulin are: Rapid-acting. Short-acting (regular). There are no short-acting insulin pens available Intermediate-acting. Long-acting. So how long can you hold on to your insulin pen after you start to use it? Rapid-acting insulin Novolog FlexPen: use within 28 days after first use Novolog cartridge (for use in a re-useable pen): use within 28 days after first use Humalog KwikPen: use within 28 days after first use Humalog cartridge (for use in a re-useable pen): use within 28 days after in-use Apidra SoloStar: use within 28 days after first use Intermediate-acting insulin Long-acting insulin Lantus SoloStar: use within 28 days after first use Toujeo SoloStar: use within 28 days after first use Levemir FlexTouch: use Continue reading >>
How Long Does Insulin Last Once It's Been Opened?
A fellow caregiver asked... My mother has type 2 diabetes and needs help with her insulin injections. After I open a new bottle, how long does insulin last for, how should I store it, and how do I know whether it's gone bad? Expert Answers As a general rule, most bottles of insulin are good for 28 days once they're opened. Of course, how quickly a person goes through a vial is highly individual. Some may go through a bottle in a week or two. Others, on a lower dosage, may not use all the insulin within four weeks. But the drug's stability and potency is only guaranteed for 28 days. Opened insulin pens typically last 14 days, though some last only 10 days. If you're uncertain, check with your mother's pharmacist to find out how long her insulin should last. When either of you opens a new vial or pen, make a note on the calendar -- and note the date when you'll need to throw out any remaining insulin. It's best to store an opened bottle of insulin at room temperature, even though manufacturers often recommend refrigeration for opened containers. It's usually less painful to inject insulin when it's at room temperature than when it's cold. Store unopened insulin vials and pen cartridges in the fridge, though, where they should last until their expiration date. Insulin shouldn't be exposed to extreme temperatures, so don't leave it in the car, next to the stove, in the freezer, or in the bathroom. If the bottle freezes, it must be discarded. Two typical signs that insulin has gone bad: poor performance and unusual appearance. If your mother is following her treatment plan and her glucose levels stay stubbornly, inexplicably high, her insulin may have lost its potency. Insulin that's cloudy when it's supposed to be clear or that contains particles, crystals, or small clumps Continue reading >>
Long-acting Insulin: How It Works
When you eat, your pancreas releases a hormone called insulin. Insulin moves sugar (glucose) from your blood to your cells for energy or storage. If you take insulin, you may need some at mealtime to help lower your blood sugar after you eat. But even between meals, you need insulin in small amounts to help keep blood sugar stable. This is where long-acting insulin comes in. If you have diabetes, either your pancreas can’t produce enough (or any) insulin, or your cells can’t use it efficiently. To control your blood sugar, you need to replace or supplement the normal function of your pancreas with regular insulin injections. Insulin comes in many types. Each type differs in three ways: onset: how quickly it starts working to lower your blood sugar peak: when its effects on your blood sugar are strongest duration: how long it lowers your blood sugar According to the U.S. Food and Drug Administration (FDA), the five types of insulin are: Rapid-acting insulin: This type starts to work just 15 minutes after you take it. It peaks within 30 to 90 minutes, and its effects last for three to five hours. Short-acting insulin: This type takes about 30 to 60 minutes to become active in your bloodstream. It peaks in two to four hours, and its effects can last for five to eight hours. It is sometimes called regular-acting insulin. Intermediate-acting insulin: The intermediate type takes one to three hours to start working. It peaks in eight hours and works for 12 to 16 hours. Long-acting insulin: This type takes the longest amount of time to start working. The insulin can take up to 4 hours to get into your bloodstream. Pre-mixed: This is a combination of two different types of insulin: one that controls blood sugar at meals and another that controls blood sugar between meals. Lo Continue reading >>
How To Use Your Lantusâ® Solostarâ® Pen A Step By Step Guide To Using Your Lantusâ® Solostarâ® Pen
For single patient use only This quick reference guide is a short version of the instruction leaflet. It is designed to help make it easier to learn the steps. Reading this guide will help to make sure that you inject the right amount of insulin every time. Otherwise you may get too little or too much insulin, and that can affect your blood sugar levels. These instructions are supplied as a guide only. Read the full instruction leaflet accompanying this pen before you use LantusÂ® SoloSTARÂ® for the first time. To help ensure an accurate dose each time, follow all steps in the leaflet. Important Safety Information for LantusÂ® SoloSTARÂ® LantusÂ® SoloSTARÂ® is a disposable prefilled insulin pen. To help ensure an accurate dose each time, patients should follow all steps in the Instruction Leaflet accompanying the pen: otherwise they may not get the correct amount of insulin, which may affect their blood glucose Please click here for full Important Safety Information and here for full Prescribing Information for LantusÂ®. If thereâ€™s anything you donâ€™t understand or if you have any questions, ask your healthcare provider. You can also go online to Lantus.com or call the support line at 1-800-633-1610. GETTING TO KNOW YOUR PEN AND ITS PARTS The LantusÂ® SoloSTARÂ® pen was designed with a simple-to-push injection button and large dosing window. Ou te r n ee dle c ap Inn er n ee dle c ap Pr ot ec tiv e se al Ru bb er se al Ins uli n re se rvo ir Do se w ind ow Do se se lec to r Inj ec tio n bu tto n Pe n ca p Ne ed le 2 Lantus.com Please click here for full Important Safety Information and here for full Prescribing Information for LantusÂ®. View a step-by-step video on how to inject at Lantus.com. CHOOSING AN INJECTION SITE The three possibl Continue reading >>
Can Insulin Go Back In The Fridge?
After removing insulin glargine (Lantus) from the refrigerator for use, can it be refrigerated over and over again after having warmed to room temperature, or does this degrade it? Continue reading >>
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 >>
How Long Do Insulin Pens Last?
Once the pen is breached with its first needle the clock is ticking. The pen now has an official life of 30 days and a realistic life of 45 days regardless of how much you use. Keeping it in the fridge will not extend its life, but will only make your shots hurt like hell. Most bodies don’t like cold fluids injected into them. Continue reading >>
Can I Use My Insulin Past Its Expiration Date?
A certified diabetes educator answers whether older insulin is still safe to use. Integrated Diabetes Services (IDS) provides detailed advice and coaching on diabetes management from certified diabetes educators and dieticians. Insulin Nation hosts a regular Q&A column from IDS that answers questions submitted from the Type 1 diabetes community. Q: Should I really worry about using insulin after its expiration date? What about using it for more than 30 days? I think the insulin companies promote that just to make us throw out good insulin. A: When it comes to insulin, we have to make darned sure that the stuff is at full potency, or blood glucose levels can go dangerously high. The insulin manufacturers are required to test their products rigorously before bringing them to market. They can more or less guarantee that their products will work as indicated if used within the expiration date and for not more than a month after the seal on the vial, cartridge, or pen is broken. This is, of course, assuming that the insulin has been stored properly and not exposed to extreme heat, freezing cold, or direct sunlight. sponsor Does this mean that insulin suddenly goes belly up at the stroke of midnight on the expiration date, or 28 days after being put into use? Hardly. Many people, including clinicians with diabetes, have used insulin beyond the “deadlines” without a hitch. It simply means that the manufacturer has not tested their product beyond the dates indicated, so there is no guarantee — no way of knowing exactly how long the insulin will remain at full strength. Read “Can I Get Insulin Over the Counter?” This is where common sense comes into play. For those with good insurance coverage and plenty of insulin on-hand, it’s best to follow the rules and discard i Continue reading >>
Two types of modern, pre-filled insulin syringes. An insulin pen is used to inject insulin for the treatment of diabetes. Insulin is a hormone produced by the pancreas. It is composed of an insulin cartridge (integrated or bought separately) and a dial to measure the dose, and is used with disposable pen needles to deliver the dose. It was introduced and marketed as NovoPen by the Danish company Novo Nordisk in 1985. Types of pens A number of companies make insulin pens including Novo Nordisk, Aventis, Eli Lilly and Biocon. These companies produce pens for most of their insulins, including NovoLog/NovoRapid, Humalog, Levemir and Lantus. There are two pen systems: durable and prefilled: A durable pen uses a replaceable insulin cartridge. When the insulin cartridge is empty, the empty cartridge is disposed of and a new one is inserted in the pen. A prefilled pen is entirely disposable. The pen comes pre-filled with insulin, and when the insulin cartridge or reservoir is empty, the entire unit is discarded. Most brands of insulin are now available for use in pens, these include: NovoMix, NovoRapid and Levemir by Novo Nordisk Lantus and Apidra by Sanofi-Aventis Humulin and Humalog by Eli Lilly and Company INSUGEN and BASALOG by Biocon Global Patient Uptake Insulin pens are used by 95% of insulin-treated patients in Europe, Asia, Australia and Scandinavia with excellent results. They are currently underutilized but growing in use in the United States. Insulin pens offer several significant advantages over insulin syringes: ease of handling, accuracy, and they are more discreet to use and easier to transport. To use an insulin pen How to prime an insulin pen. Screw or click on a new pen needle. If necessary, prime the pen to remove any air from the needle Continue reading >>
Insulin Pens Are Welcome Back To The Fridge!
We all know that unopened insulin must be kept in the refrigerator. But once in use can we put it back in the fridge to protect it from excessive heat? The answer to this simple question is not as easy as one might think. All manufacturers explicitly recommend to ‘Not refrigerate’ insulin pens in use. This guideline that causes confusion among users is now being revoked by one manufacturer. Let’s try to understand the reasoning behind it and what it means for users now. What? I shouldn’t put my insulin pen back in the refrigerator? When it comes to storing medications, it is recommended you follow the leaflet or packaging instructions. For insulin in particular, there are two different situations: storing and in-use. · Before Opening: When insulin is to be stored long-term and has not been opened, keeping it in the fridge ensures it lasts until expiration date. · During Use: Once a vial, a cartridge or a new disposable pen are used for the first time, the insulin can be kept at room temperature. But it needs to be used within weeks. It makes sense: higher temperatures and an open product mean a shorter shelf life. But there is one extra sentence on insulin pens packages, which has caused quite some confusion: Pens in use — ‘Do not refrigerate.’ What does ‘do not refrigerate’ mean for users? Let’s take a trip back to 2003, when the recommendation to not refrigerate opened insulin first appeared. Take Lilly’s Humalog for example, for which the label was first altered 14-years ago: What was the reason behind this? People started to speculate this warning was a result of preventing any kind of temperature extremes from affecting the insulin once it is in use. Many insulin users know from experience that high temperature can lower the effectiveness of Continue reading >>
How Long Does The Insulin Last? Do The Math!
In assessing an in-patient’s diabetic educational needs, I was reviewing with him his in-home regimen for his insulin therapy. Per his report, he stated that he took Levemir 50 units twice a day. I asked if it was by needle, syringe and vial preparation, which it was. I instructed him re: the shelf life of Levemir of 42 days once opened. He stated, “I throw it out after a month, but there is always insulin in the vial.” He also said he has more than an adequate supply. He was receiving his insulin by mail-order, receiving as he should, but not using it in a timely fashion. In other words, he was stockpiling his insulin. I asked him to review with me again the dosing that he takes as I reviewed the math with him. If he is taking 100 units per day and a vial contains 1000 units, his Levemir should be gone in 10 days. Both he and his wife had quite a perplexed look on their face after they did the math in their head. She stated she always left his medication management to him. I reviewed his dosing again with him and reviewed how many vials he should go through in a month. I taught them how to properly draw up and administer the insulin. He performed a return demonstration. I requested that they work together as a team and to have his wife review with him his drawing up technique for accuracy. I encouraged them to follow up with me at discharge to discuss further questions/concerns. Lessons Learned: Inform patient about how long an insulin vial or pen should last. Inform the patient how long an insulin vial or pen should last once opened. This stresses the importance of proper expiration once opened versus shelf life. Explore with the patient not only what he or she is verbally telling you, but ask how often they use a new vial or pen, and if they have extras at home Continue reading >>
How Long Does Insulin Really Last?
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. I've seen a similar thread in the past, but now I've got my own experience to go on, and I'd like to hear about yours. Your actual experience, mind - not what you've read. Now, everybody knows what the drug companies say - 28 days after first use and then get rid of it. Yet it can stay "unopened" in the fridge for 2 years. When I was researching this (will try to give references if I can find them again) the papers I found cited several factors for length of original potency: When I was using vials, I always left them in the fridge. Injecting cold doesn't bother me, but if it bothers you, let the syringe warm up instead of the whole bottle. I could routinely go 45 days with no loss of potency (Lantus). I've never had vials of Novolog, so I can't speak to that. The pens change things, because there is no added air. They have caps, so no light. Don't carry them around, so no motion. I can see no reason why they cannot be used until their expiration date. I've got a NovoPen I've been using (from the fridge) for 2 months, and it works just fine. Also, I've still got a pen (Novolog) that I started using November 4 (it has been room temp for that time). I do carry it with me (as a backup) - mostly I 'm at home for meals. I do check for cloudiness, etc, but so far so good. Used it recently, and I did shoot 5 U, instead of the 3 U I would with fresh, and worked just as expected. Yes, after 3 months it's time to change it out. So I'm asking about two things really. One is saving money - why throw it out when it is fine if kept cold? I'm sure big Pharma likes it only good 28 days - why that magic numbe Continue reading >>
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Insulin Pens: Improving Adherence And Reducing Costs
The advantages offered by insulin pens may help improve patient adherence. Currently 8.3% of the United States adult population, or 25.8 million people, have diabetes. Of these cases, more than 90% are cases of type 2 diabetes mellitus (T2DM) and at least 1 million are estimated to be cases of type 1 diabetes mellitus (T1DM). Although a variety of oral medications are available for patients with diabetes, insulins remain an important component of treatment.1,2 Insulins are the standard therapy in patients with T1DM and are ultimately used in patients with T2DM who do not respond adequately to other treatment modalities. Although in some settings insulins may be administered intravenously (eg, with an insulin pump), the vast majority of insulin administrations are subcutaneous injections.1,2 Available Forms and Administration In the United States, 2 types of insulins are available: recombinant human insulins and insulin analogs. Recombinant human insulin is available from 2 manufacturers (Humulin by Eli Lilly and Novolin by Novo Nordisk); each of these is available in a regular form and in a longer-acting neutral protamine hagedorn (NPH) form. Unlike recombinant human insulins, insulin analogs are structurally modified forms of insulin that are designed to either lower blood sugar rapidly or maintain low blood sugar levels over time. These insulin analogs may be classified as rapid-acting and long-acting insulins. Rapid-acting insulins include insulin lispro, insulin aspart, and insulin glulisine, and long-acting insulins include insulin glargine and insulin detemir. Premixed formulations of insulin are also available.1,2 Regardless of the differences between insulin formulations, all conventional types of insulin can be administered subcutaneously. Subcutaneous injectio Continue reading >>