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 >>
Diabetic Pet Basics All Owners Need To Know
Certain fundamentals apply to every diabetic pet, dog or cat, young or old. These are the things you need to know about the insulin you administer to control his diabetes mellitus. Schnauzers make up a large percentage of diabetic dogs. These basic rules also apply to diabetic cats. Pick two times of day, exactly 12 hours apart, that you can administer your pet’s insulin. Be consistent, and stick to that schedule as closely as you possibly can. It is important for your pet to have consistency in scheduling, eating, everything. Feed your pet at the time of the injection, then again 2-4 hours later, which is about the time the insulin’s effect peaks. Divide your pet’s thorax (the part of the body where the ribs are) into 7 parts. Sunday’s injections go at the front of the thorax, and each day moves back a little further. Injections administered in the neck area are poorly absorbed and the back end of the body is more sensitive to pain. Give the morning injection on the left side, the evening injection on the right side. Use the three-fingered, pyramid technique to lift the skin, then put the needle into the base of the pyramid. Using a two-fingered technique, or letting your two fingers get too close to each other, creates a wall instead of a pyramid, and makes it more likely that you might go all the way through, spraying your pet’s fur with insulin. Put the needle in all at once and get it over with. Dilly-dallying just allows a greater risk of pain. If you do perform a “fur shot,” do not repeat the insulin injection unless you are absolutely sure that none of the dose went into his body. Insulin must not be allowed to become warm, so be sure to put it back in the refrigerator (top shelf, which is not too cool) as soon as you finish drawing up each dose. W Continue reading >>
Keeping An Eye On Your Insulin
For millions of people with diabetes, technology has supplied us with wonderful, helpful aids to help control blood sugar. While some of these medications come in pill form and remain stable when stored out of light and at moderate temperatures, people with diabetes who use insulin need to depend on more than technology to make sure their insulin is in top form. As associate dean and professor of pharmacy at Washington State University, a certified diabetes educator and a person with diabetes for more than 50 years, Keith Campbell knows the importance of keeping an eye on insulin. Campbell believes that establishing a routine surrounding insulin use helps ensure the product stays potent and stable. Step One: Check the Label Campbell advises that the first thing a person with diabetes should do is check the insulin’s expiration date, even before leaving the pharmacy. “Drug companies and the FDA are very conservative with the dates,” says Campbell. This means they tend set expiration date at the earliest time the insulin could possibly go bad, and sometimes even earlier. Sofia Iqbal, RPh, a drug information scientist with Novo Nordisk Pharmaceuticals, confirms this. “Expiration dates and storage guidelines are based on stability data obtained for batches of each formulation of insulin,” Iqbal says. She adds that the dates are valid as long as the insulin is kept stored under the correct conditions. “Never use insulin after the expiration date printed on the label and carton,” Iqbal warns. If you get your insulin home and discover the expiration date has passed, what should you do? Campbell advises that you return it to the pharmacy immediately for replacement. Step Two: Examine the Insulin Eli Lilly and Company’s Kara Appell, RPh, a medical information adm Continue reading >>
Beware Summer Extremes With Insulin
Living with diabetes blog With summer arriving in Minnesota and many other places, I'd like to talk about how to manage insulin storage in extreme temperatures such as this season brings. A number of years ago, I met with a client who used a rapid insulin pen for meal dosing. She shared with me a story of how she attended the county fair on an exceptionally hot day, and had placed her insulin pen in the back pocket of tight jeans and walked around the fairgrounds all day. She used the pen for covering meals eaten at the fair, and her blood sugars were running higher than normal, but she related this to all the junk food. The next day her blood sugars continued to run high and when she took her (rapid) insulin, it didn't seem to affect her blood sugar level at all; in fact, it was like she was taking water instead of insulin. She wondered if the heat had affected her insulin, so she switched to a new insulin (disposable) pen, and soon after her blood sugars started to drop. Has this or something similar happened to you? I looked at insulin manufacturers' websites and found that for the majority of all types and brands of insulin, the maximum temperatures recommended are as follows: Opened room temperature insulin should not exceed 86 F (30 C) with the exception of Lantus, which should not exceed 77 F (25 C). Most manufacturers of insulin recommend discarding insulin if it exceeds 98.6 F (37 C). Other non insulin diabetic injectable medications: Glucagon and Byetta should not exceed 77 F (25 C). Symlin should not exceed 86 F (30 C). Avoiding potential problems Temperatures exceeding manufacturer's recommendations for insulin/medications Store your insulin in the refrigerator, in an insulated case or cooler with a freezable gel pack, or use a cooling wallet. Cooling wallet Continue reading >>
NovoLog® Storage Home or Away, NovoLog® Goes With You NovoLog® lasts up to 28 days without refrigeration after first use, so it can be taken almost anywhere. Once in use, NovoLog® FlexPen® must be kept at room temperature below 86°F for up to 28 days. Its ability to stand up to heat is equal to, or better than, other major fast-acting insulin brands. Here is a quick guide to NovoLog® storage: Storage for NovoLog® FlexPen® 3 mL PenFill® cartridge,a and 10mL vial: Temperature Use up to In useb,c (opened) Room temperature: up to 86°F 28 days Not in use (unopened) Room temperature: up to 86°F 28 days Not in use (unopened) Refrigerated: 36°F to 46°F Expiration date a3 mL PenFill® cartridge is available for NovoPen Echo®. bFlexPen® and PenFill® cartridges in use (opened) must NOT be stored in the refrigerator. cIn use vials (opened) may be stored in the refrigerator. Do's: Don'ts: Do store unused NovoLog® in a refrigerator between 36° to 46°F (2° and 8°C) Don’t store NovoLog® in the freezer or directly adjacent to the refrigerator cooling element Don’t freeze NovoLog® or use NovoLog® if it has been frozen Don’t draw NovoLog® into a syringe and store for later use Do keep vials at temperatures below 86°F (30°C) for up to 28 days after initial use. Opened vials may be refrigerated Do use unpunctured vials until the expiration date printed on the label if they are stored in a refrigerator Do keep unused vials in the carton so they will stay clean and protected from light Don’t expose vials to excessive heat or light Do keep NovoLog® FlexPen® at temperatures below 86°F (30°C) for up to 28 days once it is punctured Don’t store in use NovoLog® FlexPen® in the refrigerator Do keep NovoLog® FlexPen® and all PenFill® cartridges away from Continue reading >>
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 >>
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 >>
How Long Can Insulin Stay Out Of Fridge Temps.
How long can insulin stay out of fridge temps. 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. How long can insulin stay out of fridge temps. How long is it ok to keep insulin at normal room temperatures and maybe warmer for? I'm concerned about my 8 hour flight next week to NY. My 4 months insulin suply will be with me in my hand-lugage for whole 2 days before i will be able to refrigerate it. I don't usually keep my pens in the fridge at all, just the insulin I haven't opened, my pens are usually ok for a week. I'm just concerned about my hwole 4 months suply getting too warm Laura Lu, Your insulin should fare just fine for your eight hour flight. Keeping it in your hand luggage is smart. The planes are kept at a comfortable temp for insulin. Refrigerate it when you arrive and you will be just fine. If you feel so inclined you can get freezer packs, but you will have to do some fancy explaining at the gate. Usually, you can get your packs through the inspection if you have adequate reason. KGM managed to get her freezer packs through hand luggage inspection by claiming she needed to keep her insulin cool. All they can do is make you throw it out. Yea,for 8 hours insuline is ok....!!!but be careful,if insuline dosen't work buy new package of insuline... My insulin was fine when I flew from NY to Ireland a few years ago. I had to keep it in my luggage in a hostel for a WEEK before i finally found a flat and could use the refrigerator. I was a little nervous about the whole 6 month supply going bad, but it was fine. This was, however, in Ireland in winter. During those 2 days will you be in airports / airplanes and hotels that have a/c for Continue reading >>
Treatment, Most Of Them Do Very Well And Have Decent Quality Life Spans.
Diabetes We have just diagnosed your cat with diabetes. We see a lot of cats with diabetes, and with proper care and Cause and Types: ï‚· Every time your cat eats, they ingest glucose in various amounts. To be able to metabolize this glucose, their pancreas secretes insulin, which allows the cells to be able metabolize the glucose. ï‚· Diabetes happens when they either are not producing enough insulin, or when their cells are insulin resistant, and require higher levels of insulin to be able to metabolize the glucose. ï‚· When glucose cannot be adequately metabolized, it starts to build up in the blood stream, resulting in various problems. This is diabetes, also known as hyperglycemia. ï‚· There are two types of diabetes, type I and type II. o Type I diabetes is caused by failure of your catâ€™s pancreas to produce enough insulin for the bodyâ€™s needs. There are several factors that can affect this. ï‚§ Acute or chronic pancreatitis can damage the pancreas enough so that the pancreas can no longer secrete an adequate amount of insulin. ï‚§ This can also be congenital, although congenital type I diabetes is fairly rare in cats. ï‚§ Idiopathic is our third cause. Idiopathic is a medical term that means we have absolutely no idea what caused it. o Type II diabetes is when the cells of the body become insulin resistant, and require higher and higher levels of insulin to be able to function. ï‚§ This is most commonly caused by increased levels of fat. Fat cells produce hormones that can cause insulin resistance, and the more fat cells present, the higher likelihood that insulin resistance requiring treatment will occur. ï‚· Regardless of the type and cause, in cats they are both treated the same way. For people with type II dia Continue reading >>
Tracking Insulin's Health In The Summer Heat
Sunscreen: check. Water bottle: check. Beach ball: check. Insulin cooler....? Yep. For those of us who use insulin, summer heat creates an extra level of complexity and worry. The real question we all ask ourselves in the heat of the summer is whether our fun-in-the-sun will cook our insulin and leave us having-not-so-much-fun in an air conditioned ICU unit? There's a whole industry of solutions dedicated to helping us keep our insulin cool, ranging from cooling packs such as the ReliOn and others, to portable fridges, to high tech cooling crystals. Hell, we're even running a Giveaway contest this week in which our readers can win some of these products! With much of the U.S. suffering under a stifling drought-baked summer, the question of just how hot insulin can get is on all our minds. But you have to wonder if these products are serving an important need or just preying on our fears. To find out, we asked the manufacturers themselves, some leading insulin experts, and the American Diabetes Association — and guess what? The answer isn't as clear as you might like. Not Your Grandma's Insulin First, a bit of history: Didn't grandma keep her insulin in the fridge all the time? Well, only if she read the label. The original pork and beef insulin formulations were supposed to be kept cold all the time. As cold insulin stings like hell to inject, the move to being able to keep the newer human insulin and later analogs at room temperature was a great victory (!) for those of us who are human pin cushions. But wait a minute... whose room temperature are we talking about? My father used to get annoyed with me when I'd shovel ice cubes into my glass of red wine. "Wine is supposed to be consumed at room temperature," he'd huff. "Yeah, in the frickin' French Alps,where room te Continue reading >>
Insulin Use Tips
Before each use, take a moment to inspect the insulin prior to drawing it into the syringe; clear insulins should appear not discolored and clear; suspended insulins should be uniform in their cloudiness.  Do not use the insulin if: The bottle looks frosted.  Clear insulin that looks discolored or has turned cloudy, contains particles or haze.  Cloudy insulin that appears yellowish or remains lumpy or clotted after mixing.  See Insulin problems for more information about "bad" insulin. Damaged Insulin: Insulin that is getting too old, or has been dropped or shaken or mishandled, or exposed to a lot of light or heat, will be less effective than before. Freezing  destroys the molecules of ANY insulin; any that has either been frozen or is suspected of having been frozen should not be used. Insulin which has been frozen will not be able to do an effective job of controlling blood glucose.  Check for discoloration or floating objects in the insulin -- it may also be contaminated. It's also possible that the new or newer vial from the pharmacy may be flawed. If you've recently started it and are having problems, this might be the case. Taking down the lot number and getting a new vial that has a different batch/lot number should take care of this. Frosted insulin: If insulin is subjected to temperature extremes, such as freezing or overheating, the insulin can precipitate  on the vial's walls, giving it a frosty or frosted appearance. Another term used to describe this is flocculation.  In the photo above, the insulin vial on the right is a visual example of what a frosted vial would look like. You can see the precipitated insulin clinging to the sides of it. The problem seems to be a particular one with R-DNA/GE/GM NPH Continue reading >>
Storage & Travel
Do not take Tresiba® if you: are having an episode of low blood sugar are allergic to Tresiba® or any of the ingredients in Tresiba® Before taking Tresiba®, tell your health care provider about all your medical conditions, including if you are: pregnant, planning to become pregnant, or are breastfeeding taking new prescription or over-the-counter medicines, vitamins, or herbal supplements Talk to your health care provider about low blood sugar and how to manage it. Read the Instructions for Use and take Tresiba® exactly as your health care provider tells you to Do not do any conversion of your dose. The dose counter always shows the selected dose in units Know the type and strength of insulin you take. Do not change the type of insulin you take unless your health care provider tells you to Do not take Tresiba® if you: are having an episode of low blood sugar are allergic to Tresiba® or any of the ingredients in Tresiba® Before taking Tresiba®, tell your health care provider about all your medical conditions, including if you are: pregnant, planning to become pregnant, or are breastfeeding taking new prescription or over-the-counter medicines, vitamins, or herbal supplements Talk to your health care provider about low blood sugar and how to manage it. Read the Instructions for Use and take Tresiba® exactly as your health care provider tells you to Do not do any conversion of your dose. The dose counter always shows the selected dose in units Know the type and strength of insulin you take. Do not change the type of insulin you take unless your health care provider tells you to Adults - If you miss or are delayed in taking your dose of Tresiba®: Take your dose as soon as you remember, then continue with your regular dosing schedule Make sure there are at least 8 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 Can You Leave Insulin Out Of The
How long can you leave insulin out of the A: All the insulin manufacturers recommend throwing out the rest of the insulin in the vial, because they cannot guarantee the insulin is still good. An unopened cartridge should be kept in a refrigerator at between 2 to 8 degrees Centigrade and away from the cooling element (I keep theApr 25, 2017 Storing insulin right. Always read the instructions that come with your insulin. Should it be in the fridge, is it sensitive to light, can it Just remember to take insulin out of the fridge awhile before injecting and don't store pens with needle attached. This also assumes that theDo not leave in sunlight. ) . In the main you can keep your insulin out of the fridge for upto a month. Can Insulin Go Back in the Fridge? As long as vials or pens are stored unopened in the refrigerator keep insulin on your person or in your carry-on bag. Find out the Insulin. Opened insulin pens typically last 14 days, though some last only 10 days. Insulin Storage and Syringe Safety. Never leave insulin in the sun or in your hot car, because sunlight and heat reduces the strength of the insulin. Never let theKeep spare vials or cartridges of insulin in their boxes in the fridge. Light can make insulin break down and then it will not work well to lower your blood sugar. This was a definite problem in years gone by, if insulin was stored out-of-spec, and could occur if insulin is frozen or overheated. (No kidding. As long as vials or pens are stored unopened in the refrigerator (at 36 to 46 degrees Fahrenheit), they are good until the expiration date on the container. Q: I use an insulin pen. This could cause contamination and/or infection, or leakage of insulin, and may interfere with accurate dosing. You must throw away after 28 days since outsideAug 5, 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 >>