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Spoiled Insulin

Insulin Use Tips

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. [1][2] Do not use the insulin if: The bottle looks frosted. [3][4][5][6][7][8] Clear insulin that looks discolored or has turned cloudy, contains particles or haze. [9] Cloudy insulin that appears yellowish or remains lumpy or clotted after mixing. [10][8] 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 [11] 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. [12] 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 [13] on the vial's walls, giving it a frosty or frosted appearance.[5] Another term used to describe this is flocculation. [7][14] 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 >>

Dka – What You Need To Know By A Certified Diabetes Educator

Dka – What You Need To Know By A Certified Diabetes Educator

Q – My doctor told me I needed to do ketone testing. What is it, how is it done and why is it important? A – When you live with diabetes, there’s a lot to juggle. It can be understandable if your eyes glaze over when your physician or diabetes educator mentions ketone testing (another test!), but here’s why you should take this part of your treatment plan seriously: Ketones are acid molecules generated when we burn fat for energy. This isn’t a problem as long as it doesn’t happen in excess. When you flood your body with too many acids, it starts to become toxic. Combined with dehydration and high blood glucose levels, it can lead to a life-threatening condition called diabetic ketoacidosis (DKA). Often, DKA can occur when you’re not able to get enough glucose into your cells to burn as energy, and the body relies almost exclusively on fat for fuel. This can occur for a number of reasons: • Illness and infection (which can cause intense insulin resistance and elevated blood sugar) • A lack of insulin in the body (due to missed injections, spoiled insulin, or poor absorption) • Insulin pump malfunctions (clogs, leaks, air pockets, cannula displacement, prolonged disconnection, failure to prime the tubing, or accidentally erasing the basal settings) This is very different than nutritional ketosis, which is caused by starvation, prolonged fasting, or a severe lack of carbohydrates in one’s diet. READ THE ENTIRE ARTICLE AT: insulinnation.com Continue reading >>

Death By Expired Insulin Prescription

Death By Expired Insulin Prescription

A family’s grief leads to a bill that would allow pharmacists to dispense insulin without a current prescription to save lives. It’s been 16 months since Dan and Judy Houdeshell lost their son, Kevin, and they are trying to accept that they may never know exactly what happened. Kevin, who was on insulin therapy, was found dead in his home in Sheffield Lake, Ohio on January 8th, 2014. He had been without insulin for nine days at the time of his death. Dan and his family have tried to reconstruct those last days the best they can, talking with Kevin’s co-workers and examining text messages Kevin sent. “The last four days, he was by himself,” Dan says. “I can only imagine…no, I can’t even imagine what it was like.” sponsor There were many steps that led to Kevin’s death. The path may have included some less-than-perfect choices in his self-care, and bad luck; there is still so much that isn’t known. Dan is certain, however, of the first action that set off the chain of events that led to Kevin’s death: he was denied insulin at a local pharmacy on New Year’s Eve. Since then, Dan and his family have been calling for a change to Ohio state law to expand the prescribing authority of state pharmacists so people on insulin therapy, and those who need other life-saving medications, need not walk away empty-handed. The Ohio legislature is taking up a bill that would incorporate these changes into law. Dan hopes Kevin’s death might lead to a change that can help others. “It doesn’t really help us with the grieving process, it’s just something we have to do,” he says. “We don’t want this to happen to anyone ever again.” The DKA spiral Here’s what happened: On December 31st, 2013, Kevin was out of insulin and tried to get some at the pharma Continue reading >>

Insulin For Diabetes Treatment (types, Side Effects, And Preparations)

Insulin For Diabetes Treatment (types, Side Effects, And Preparations)

What is the dosage and how is insulin administrated? A meal should be consumed within 30 minutes after administering regular insulin Insulin usually is administered by subcutaneous injection into the abdominal wall, thigh, buttocks (gluteal region), or upper arm. Injection sites should be rotated within the same region. Some insulins (for example, regular insulin) also may be administered intravenously. The dose is individualized for each patient. A combination of short or rapid acting and intermediate or long acting insulin typically are used Some patients may develop resistance to insulin and require increasing doses. Multiple daily insulin injections or continuous subcutaneous infusions via a pump closely mimic pancreatic insulin secretion. Insulin sliding scales (doses of insulin that are based on the glucose level ) may be used for managing critically ill hospitalized patients. What are the contraindications, warnings, and precautions for insulin? Hypersensitivity to insulin or its excipients (inactive co-ingredients) Hypoglycemia may occur and is the most common side effect of insulin treatment. Severe, life-threatening allergic reactions, including anaphylaxis, may occur. Hypokalemia (low blood potassium) may occur because insulin stimulates movement of potassium from blood into cells. Combining insulin with potassium-lowering drugs may increase the risk of hypokalemia. Hepatic (liver) impairment may reduce the insulin requirement. Renal (kidney) dysfunction may reduce the insulin requirement. Illness, emotional disturbance, or other stress may alter the insulin requirement. Intravenous administration increases the risk of hypoglycemia and hypokalemia. Continue reading >>

Taking Lantus®, Taking Action: Watch Real Success Stories

Taking Lantus®, Taking Action: Watch Real Success Stories

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 >>

Insulin Angel – The Smart Medication Tracker

Insulin Angel – The Smart Medication Tracker

8th April - Diabetes is a chronic medical condition that affects more than 380 million people worldwide. Its impact on global healthcare spending is immense: it is estimated that one in nine dollars of healthcare spending is spent on diabetes. Many innovations like pumps, pens and blood glucose-monitors make life with diabetes much easier than it used to be, but there are still countless daily challenges people with diabetes have to cope with. Insulin Angel, the first temperature and proximity medication tracker, is the first product which addresses two of these challenges: keeping insulin at a safe temperature, and not losing or forgetting the medication or the medical kit. Designed by Pilotfish, Insulin Angel consists of a small device connected to a phone application via Bluetooth Low Energy. The device is placed with the medical kit, together with the medication and glucose-monitoring device and tracks the ambient temperature. The user is notified by the App when temperature approaches a critical level or when it exceeds it. Insulin Angel can also be kept with the stock of insulin in the fridge and alerts if storage conditions change in absence of the user, for example if the fridge is broken and stops cooling, or if it malfunctions and gets below the appropriate cooling point. Insulin Angel helps people reduce the amount of medication wasted because of doubt, and decreases the risk of taking ineffective or spoiled insulin. Insulin Angel is useful not just to diabetics but to every person with a medical condition who relies on vital medication/equipment. The initial release of Insulin Angel will support some asthma and rheumatism medications. Marc Nagel, Pilotfish Co-founder and the father of a child with type I diabetes got involved with the project, leading the pr Continue reading >>

No More Worrying About Insulin – Diabetes Daily Review

No More Worrying About Insulin – Diabetes Daily Review

“How often do you wonder whether the insulin you have with you has spoiled due to varying temperatures? I know I worry about the insulin that stays in my testing case, whether I’m traveling or even just going out for the day. Especially when you get to the bottom of the vial and the insulin just doesn’t seem as potent as it did when it was first opened. MedAngel hopes to help alleviate some of our worries with their temperature sensor. It’s a small device, just about the length of an insulin vial. It easily slips into any case or bag, where ever you prefer to keep your insulin when traveling. At $49.00, it’s well worth it if you are one to be worried about how temperatures can affect your medications.” Sarah, T1D Sugabetic.me Continue reading >>

When Good Insulin Goes Bad.

When Good Insulin Goes Bad.

Ninety percent of the time, my high blood sugar has an identifiable reason, and there’s a cluster of common causes. Did I under-estimate the carbs in a snack and therefore under-bolus? Did I over-treat a low blood sugar? Did I eat without bolusing at all (it happens)? Is there a lot of stress floating around that I’m responding to? Most of the time, those questions cover the why. Once in a while, my highs are for rogue reasons, like an air bubble in my pump tubing. Or when I eat something carb-heavy right after an insulin pump site change (it’s like that first bolus doesn’t “catch” somehow). Or I forgot to reconnect my pump. Or if the cat bites through my pump tubing. But rarely, if ever, is one of my high blood sugars the result of bad insulin. Except it totally happened last week, when two days of bullshit high numbers had me mitigating every possible variable … other than swapping out the insulin itself. (And clearly I’m stubborn and/or in denial about the quality of my insulin’s influence on my blood sugars?) I rage-bolused. I exercised. I low-carbed the eff out of an entire day. I did a site change at midnight to take a bite out of the highs. Nothing. The downward-sloping arrow on my Dexcom graph had gone on hiatus. (Always a punched-in-the-gut feeling to see the word HIGH on a Dexcom graph, accompanied by an up arrow.) But ditching the bottle of insulin entirely and swapping in a new Humalog vial? That did the trick in a big way. For once, it was the insulin. Next time, it will surely be the cat. Share: Continue reading >>

Type 2 Diabetes: Signs And Symptoms

Type 2 Diabetes: Signs And Symptoms

Diabetes mellitus is a metabolic disorder of the pancreas that affects the protein, carbohydrates and fat metabolism. There are two major forms of diabetes mellitus, the Type 1 and Type 2. Type 1, it is formerly called as Insulin-dependent diabetes or Juvenile diabetes. This disease usually affects children, teenagers and young adults. It is characterized by no insulin production by the beta cells in the islet of Langerhans of the pancreas. Type 2 Diabetes Mellitus or Non-insulin-dependent diabetes, runs in the families; it is also called Adult-onset diabetes. It is characterized by insulin resistance or insufficient insulin production. The manifestation occurs when the beta cells of the islet of langerhans secrete insulin into the bloodstream, but the blood glucose level remains elevated because of the peripheral insulin resistance and increased conversion of glycogen to glucose by the liver. Family hstory and Obesity are the major risk factor in developing type 2 diabetes. Obesity is linked to insulin resistance, because an excessive fat makes it difficult for the cells to react to insulin. Being Obis or overweight makes people inactive; as a result, this reduces further the body’s ability to respond to insulin. In the past, more adults are more likely to develop this form of diabetes because they are more prone to be obis, but today, there are more kids and teenagers who are diagnosed with type 2 diabetes. Children who are in the puberty stage are also more at risk because the rise of hormone levels that can cause insulin resistance. Signs and symptoms might vary in every person who is suffering from this disease. People may not find out that they have the disease until such time they suffered from diabetes complications. Some people might already have the symptoms Continue reading >>

Hyperglycemia

Hyperglycemia

Hyperglycemia, or high blood glucose, occurs when blood glucose rises above your recommended range. Your healthcare professional will determine the proper healthy blood glucose range for you. High blood glucose can be caused by many things, including: Eating too much food Little or no physical activity Not taking medications Stress, infection or illness Bad or spoiled insulin High blood glucose can cause serious problems and a major cause of long-term diabetes complications. Warning signs of high blood glucose include: Tiredness or fatigue Increased thirst Frequent urination Blurred vision Dry mouth or skin Slow-healing cuts and sores Unexplained weight loss It is important to keep your blood glucose level within your target range. Checking your blood glucose often may help you avoid hyperglycemia. During illness your blood glucose levels can increase because of the hormones in the body that are helping you to get better. If you have type 1 diabetes you may need more insulin when you are sick, talk to your healthcare provider. Continue reading >>

Tracking Insulin's Health In The Summer Heat

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 >>

Keeping An Eye On Your Insulin

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 >>

Keep Your Insulin At A Safe Temperature With Medangel

Keep Your Insulin At A Safe Temperature With Medangel

I recently had the opportunity to chat with MedAngel’s founder, Amin Zayani. MedAngel is a device that helps people keep track of the temperature of their medicine. Amin and his brother both have type 1 diabetes, and in our interview, he shared his personal experience dealing with insulin that was not kept cold enough. He also explained some of the challenges and excitement he has faced since he launched MedAngel. Tell us about MedAngel. What does the device do and how? MedAngel ONE is a wireless Bluetooth temperature sensor that is kept with your medications. It continuously measures the temperature and communicates with an app on your phone. The app knows the safe ranges for stored or opened medications and alerts you only when there is a real danger. What is your personal connection to this company and how did the idea come about? I started MedAngel after a very frustrating experience one summer day in 2013. I was injecting loads of insulin to correct my high blood glucose, but it was not having any effect. I had to run to the hospital to get my blood sugars stabilized. I got lucky and did not go into diabetic ketoacidosis (DKA) that day. Instead, I was given a fresh batch of insulin. Things got back under control, but I wanted to know what the cause of the incident was. I started investigating how well my refrigerator worked and realized that it was the source of the problem. The temperature inside it fluctuated between -2 and +12 degrees C! This is totally outside the recommended range (2-8 degrees) and it was irreversibly reducing my insulin’s effectiveness. At the time, I worked at a startup that helped developers build apps connected with all kinds of wireless sensors. I realized I had the skills and tools to find a solution and make sure the problem did not Continue reading >>

Think Like A Pancreas//your Cheat Guide: Chapter 9

Think Like A Pancreas//your Cheat Guide: Chapter 9

Going to extremes Part II: Dealing with high blood sugars. When we first think of high blood sugars, our mind instantly thinks of that post-meal spike. That moment you that thought you calculated just right........ but then 2 hours later your meter magically reveals: 251 [insert indifferent face here]. We have all experienced this as Type 1’s. #ifeelyourpain Apart from the obvious calculating (and miscalculating), are you aware of the two HUGE things working against us? Insulin timing and amylin. _______ You and your friend just ordered some delicious cupcake’s from your favorite bakery. You both sit down. She instantly bites into her gooey red velvet cupcake, and you guesstimate the 51 carbs, dose, and then indulge in your peanut butter chocolate cupcake. Her body immediately releases insulin & amylin—both helping to keep blood sugars stable and minimize any spike. As a Type 1 diabetic, you have neither of these hormones. You are 100% dependent on your insulin dose and the perfect timing of when to dose -- It can take 15 minutes to start working, 60-90 minutes to peak, and 3-5 hours to finish working. While insulin is the obvious (major) hormone we lack as Type 1’s, amylin may be something you are unaware of. In reality, we can (and clearly do) live without amylin, but not having amylin is a huge factor on why our levels rise so quickly post-meal and why it’s extra important to take our doses at least 10 to 15 minutes before. So what exactly is it? “At the base of the pancreas is a cluster of cells called the islets of Langerhans and contained within those cells are the cells that constantly measure blood glucose levels and produce insulin as needed to keep blood sugar within a normal range. Along with insulin, beta cells secrete amylin, a hormone that, amo Continue reading >>

Beware Summer Extremes With Insulin

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 >>

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