
Can Humalog Handle The Heat?
See also: Kinetic vs Dynamics and User's Reports Humalog is a terrific insulin that improves postmeal readings, reduces the frequency of lows, and generally makes people feel better. But reports from people on both pumps and injections have surfaced indicating that Humalog has trouble handling the heat. These reports began to appear just after Humalog was released. Most insulins are relatively stable in hot weather, and lose potency only with unusually high temperatures (i.e., a non-refrigerated delivery truck with a flat tire in Phoenix in August). However, Humalog has gained a reputation for wanting to stay in your refrigerator, raising concerns about how your insulin is handled in transit to your pharmacy or home. Users report random, unexpected high blood sugars that correct when a new bottle of Humalog is started. Inspection of the bad bottle reveals either 1) several very tiny particles, much smaller than those typically found in a bad bottle of Regular, 2) one or two large hazy particles, or 3) small particles attached to the insides of the bottle. Healthy Humalog will appear as pure as clear water, with no particles or haze. Insulin pumps may be especially prone to unexpected highs because they use only Humalog. Heat-related problems typically start after three to four days use in a pump, or, when a bad bottle is encountered, immediately after first use of that bottle. On injections, the problem typically shows up as unexpected high readings after meals. Research studies undertaken so far have indicated no problem with use of Humalog in pumps. Prior to Humalog's release, Lilly conducted extensive heat and stability testing, and believed that it was as stable as Regular insulin which has an excellent history. But in the larger lab of the world, a loss of activit 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 >>

The 3 Top Tips To Store Insulin Right.
Avoid these common mistakes to keep your insulin safe and effective. The right storage is important for our medications. too Too warm or cold temperatures affect how well medicine works when we take it. Many medications, including insulin, lose their effectiveness when exposed to heat or freezing temperatures. Thankfully it does not become harmful, but a portion or all of the insulin peptides do not work anymore. There is no visible change to the medication when that happens. The result is insulin with a varying potency and blood sugars that won’t go down, without a way of knowing if it was the insulin or something else. When reading this, you might think of your beach or skiing holiday, when your insulin is exposed to heat and sun or extreme cold. However, it is actually the fridge at home that poses the biggest risk for insulin, biologics &co. Many medications, including insulin, should be kept between 36–46°F / 2–8°C, when we store our stock of a few months in the refrigerator. If you have every taken frozen tomatoes out of your fridge, you already know that domestic refrigerators are not exactly up to medical standards. They have warm and cold zones, some areas are prone to freezing, the temperature fluctuates up and down every few hours and you need to adjust the settings over changing seasons and when the fridge gets older. You don’t even need to think of a worst case scenario, like your insulin completely freezing and becoming ineffective. When you keep medication stocks in your fridge for weeks or months, why not try to get it right? Even exposure to a few degrees lower or higher outside the recommended range add up over a longer time and can gradually lower insulin effectiveness. Don’t worry, there is no need for investing in a new fridge now! With Continue reading >>

Insulin Gets Hot, But Still Works?
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 go to the beach alot, and during the summer, I carry my humalog pens and lantus pens around, and I can feel that the insulin is, not "hot" but its warm, and my doctor told me that if insulin gets warm it expires, and acts just like water being injected. I still use it when its warm, and it works fine, same with the lantus pens. Anyone have any information on when insulin actually expires from heat? Or experiences...anything...thanks! Each insulin is different but I believe the range is 85-95 degrees. If it reaches that temp it starts to break down and possibly even crystalize. I had a novo pen in my car for almost a year after starting the pump. It went through a hot midwest summer (in car temps ~ 100+ degrees) and a cold winter (temps ~ less than 0 degrees). One day I went out for lunch and forgot that my pump was almost out. Needless to say, by lunchtime my pump had only 3 units of insulin left. I decided that even if the novolog left in the pen was not full strength it was better than nothing... it actually worked great (maybe even a little better) Since then I have used it a couple more times with no problems. I can't explain why this happened but tempature or age didn't seem to affect the insulin's potency. I go to the beach alot, and during the summer, I carry my humalog pens and lantus pens around, and I can feel that the insulin is, not "hot" but its warm, and my doctor told me that if insulin gets warm it expires, and acts just like water being injected. I still use it when its warm, and it works fine, same with the lantus pens. While anecdotal eveidence indicates that you are fair Continue reading >>

How To Protect Medications From Extreme Temperatures
Safely storing a senior’s meds can be a challenge, especially during the summer and winter months. But, did you know that exposure to extreme temperatures could render medications ineffective or even dangerous? Prescription and over-the-counter drugs come with inserts that detail storage guidelines, but as caregivers know all too well, mishaps happen. What happens if you accidentally leave a prescription in the car all day? What should you do if the power goes out and you can’t refrigerate a medication that says, “keep refrigerated?” Papatya Tankut, Vice President of Pharmacy Affairs for CVS Health, answers some common questions surrounding the proper storage of prescription medications. Temperature Guidelines for Storing Medications According to Tankut, the ideal temperature for most medications is room temperature—anywhere between 68 and 77 degrees Fahrenheit. However, some medications commonly prescribed to seniors have specific storage instructions that caregivers should be aware of, including the following examples. Inhaled medications: Brovana, Foradil Injectable drugs for diabetes: Insulin, Byetta, Victoza, Symlin Eye drops: Azacite, Phospholine Iodide, Travatan and Travatan Z, Xalatan Other meds: Copaxone, Forteo, Fortical (calcitonin Nasal spray), Octreotide You can check the particular directions for these and hundreds of other prescriptions on the National Institutes of Health drug information website . What Happens When Medications Aren’t Stored Correctly? Prescriptions that are subjected to extremely hot or cold temperatures can lose their effectiveness prior to their printed expiration date, Tankut says. That’s why she suggests not storing a senior’s meds where they might be exposed to temperatures that fall outside of the suggested range. Continue reading >>

Hot Tips For Managing Diabetes In Cold Weather
Brrr … it’s cold out there! When you’re managing diabetes, there are a few extra things to keep in mind when the temperature drops. But don’t let the cold keep you indoors; getting fresh air every day is healthy and a great idea as you try to fit exercise into your daily routine. Blood sugars Be aware that blood sugars might not be what you expect when you are out in the cold. Some people respond to low temperatures with low blood sugars, and others will see blood sugars climb higher. The only way to know what’s happening in your body is to test frequently! Watch for trends of highs or lows in the cold, and then adjust your food and insulin accordingly. Frozen insulin Remember that insulin, like water, freezes around 32 degrees (F). That means the insulin in the pen or vial you left in the car, in the delivery left on your door step, and in the tubing of your insulin pump will freeze when temperatures are at freezing or below. Keep an eye on your insulin and make sure that it is protected from the cold. If you are outside and need to store your insulin away from your body, keep it in an insulated thermos, cooler, or specially designed storage pack to make sure that it stays above 40 degrees if possible. Insulin stored in the refrigerator can sometimes freeze, too. Keep it closer to the door of the fridge to prevent this. If you think that your insulin has frozen, throw it out and start a new vial, pen or pump reservoir. The protein in frozen insulin denatures and won’t work in the same way. Protect your electronics Electronics don’t like to be cold (or hot!). Keep your pump or CGM receiver in an inside pocket next to your body to keep it warm. For the most part, if you can keep it above approximately 40 degrees (F), your pump or CGM receiver will work. On Continue reading >>

Hot Insulin And Other Ways A Person With Diabetes Knows It’s Summer
How do you know that summer has arrived? Some may go by the calendar (June 21st) and some may mark the last day of the school year as the beginning of summer, but I have my own signs that let me know it’s summer. My signs are ones only a person with diabetes can understand. And I’ve come up with some solutions to my summer diabetes issues. If you have other ones, please share. Sweaty hands make it hard to check blood sugar. For the past few days as it has become hotter and more humid, I’m sweating more during my morning runs. I have found myself looking for something to wipe my fingers on when I stop to check my blood sugar because there is simply too much sweat on them to get an accurate reading. During the winter I just use my shirt if I need to wipe at all. But when summer comes, my clothes are too soaked in sweat and I find myself wiping my finger on trees and walls, and then trying to test my blood sugar as quickly as possible before the sweat takes over again. I know some people carry a small microfiber cloth in their glucose meter kit but my running pack is already so stuffed. Any ideas? I find myself trying to calculate the correct bolus for watermelon. I love watermelon and I live in a place that grows spectacular watermelon. It’s one of the few foods I find totally irresistible, and eating it almost always causes a blood sugar disaster. Why is it so tricky to bolus for watermelon? Watermelon has only 8g of carb per 100 grams (8%) and a relatively low glycemic load because of the high water content. However, it has a GI of 76 (way higher than orange juice), meaning it raises blood sugar very fast and without a pre-bolus it’s almost impossible to avoid high blood sugar. But a large bolus which can keep up with the quick rise in blood sugar usually mean Continue reading >>

Diabetes In Hot Weather — 12 Things To Know
To date, 2016 has been the hottest year ever, and it’s getting hotter. From now on, coping with heat will be an important part of managing diabetes. Some knowledge that might help you: 1. High body temperatures can lower blood sugar. Mayo Clinic writers Nancy Klobassa Davidson, RN, and Peggy Moreland, RN, CDE, say you should check your sugars more often in the hot weather. 2. Sunburn can raise blood sugar. The Mayo Clinic advises wearing a good sunscreen, sunglasses, and a hat while out in the sun. 3. Warm skin absorbs insulin faster, while dehydrated skin absorbs insulin more slowly. The closer you can keep your injection site to normal temperature and hydration, the better. 4. Dehydration from sweating can raise blood sugar and can lead to heat exhaustion. According to the Cleveland Clinic, people with diabetes are more likely than others to be admitted to hospitals for dehydration and heat exhaustion, and to die from it. High glucose levels lead to urinating more, which increases risk for dehydration. This may be especially true if you’re on an SGLT-2 inhibitor drug. Keep drinking water with a bit of salt if you are blessed to live in an area where water is available. Have a bottle with you and don’t wait until you’re thirsty to drink. Learn to check yourself for dehydration by pinching up some skin on your arm and letting it go. It should snap right back into place. If it goes more slowly, you are getting dehydrated. Don’t drink alcohol or caffeine in super-hot weather, as they are dehydrating. 5. Heat can damage insulin, other medications, and test strips. The Joslin Clinic advises people to keep their insulin cool, but not on ice. If you take medicines with you while you’re away from home, get a cooler bag to keep your medicines and test strips in. Ext Continue reading >>

Insulin Storage
Insulin Storage If insulin gets too hot or too cold it will not be as effective when you inject it. It is really important to store insulin at the right temperature. Ideally in the fridge in or near the salad crisper box. Insulin that is being used is ideally kept at room temperature as it is much more comfortable when injected. What happens if insulin is too hot or too cold? If insulin gets to hot or too cold it will not work properly. What is the best temperature to store insulin? The best temperature for storing insulin that is not being used is 4-6 degrees. The ideal location is in the fridge, in or near the salad crisper box, and away from the freezer compartment. What temperture does insulin work best for injecting? Insulin in use temperature should be kept at room temperature as this ensures a much more comfortable injection. Insulin will normally last around 30 days at room temperature please consult instructions for use for your specific insulin. Each type of insulin has slightly different storage needs, so always read the patient information leaflet that comes with yours. Continue reading >>

Diabetes And Hot Weather - Staying Safe In The Heat
Diabetes and Hot Weather - Staying Safe in the Heat There are hypo and hyper risks in hot weather Whether you are going on holiday or simply spending some time outdoors in the heat, high temperatures and the close humidity currently sweeping the UK do have an influence for people with long term conditions such as diabetes. This may partly be explained by increased activity in hot weather, but there is no doubt that the heat does affect some people with diabetes in other ways. What problems can hot weather cause for people with diabetes? Dehydration can be an issue in hot weather, and higher blood glucose levels can further increase this risk. People with diabetes may need to increase their intake of fluids in hot weather, drinking water regularly through the day. One of the major concerns regarding diabetes and hot weather is the risk of blood sugar levels rising or falling and causing hypoglycemia or hyperglycemia . What are the hypo risks from hot weather? Hot weather can increase the risk of hypoglycemia for those on blood glucose lowering medication. The Joslin Diabetes Centre notes that the bodys metabolism is higher in hot and humid weather which can lead to an increased chance of hypoglycemia. Hypos may be slightly harder to spot in hot weather. Dont be tempted to disregard hypo symptoms , such as sweating and tiredness, as a result of hot weather as it could be a sign of hypoglycemia. Take extra care when driving and test your blood sugar before and after each journey and stop regularly to check your blood sugar if taking longer journeys. To prevent hypos, be prepared to test your blood glucose more often, particularly if taking part in physical activity in hot weather. Keep a source of fasting carbohydrate, such as glucose tablets, to hand. To help treat hypos 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 >>

Does Hot Weather Screw Up Insulin???
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. OK...I dont understand WHY this is happening.. Ever since its been getting Majorly HOT here in SoCal. I've had to "increase" my Insulin Units before eating!....Even that doesn't keep my Glucose level under 130 when testing!...WTF! I have NOT changed the stuff I eat either SAME stuff before it got Hot. Does anyone know if the Hot Weather messed up my INsulin or something????......Just Frustrated in not being able to maintain a stable level through the day!!!! Here's a good read regarding Humalog, but I imagine it would apply to other insulins as well. Its like ****...I been having to almost double my Insulin it seems like...Sometimes...when I do...I come too low too!! Yes, insulin needs to be kept at a reasonable temp. However, the heat may be affecting *you* as well, so it's not necessarily the insulin that isn't heat-resistant. Prior to pumping I also used the Novolog Pens and found, especially in the Summer months, that I could only use it for 14-17 days and not the entire month. just to follow up on the idea it might be you not the insulin... I have to increase my basal insulin by up to 30% on hot days, due to insulin resistance in my body. This is consistent and has occurred for me for many years. Just like stress can affect us and how effective our insulin is, so, it seems, temperature can affect us too. So, just understand that this does happen to other people. How to tell if it's your insulin or you? I guess, be sure your insulin is relatively fresh and see if it still occurs. By relatively fresh, I mean that it would definitely have to be really really hot (or be left in sunlight) for Continue reading >>

Heat Harms Insulin, Meters, And Even Some Oral Drugs!
A recent article in Science Daily reports on a presentation given at this week's meeting of the Endocrine Society. It's worth a look: Science Daily: Many People with Diabetes Do Not Know or Heed Dangers of Hot Weather Unfortunately, while the points it makes are true, a much better title would have been Many doctors and pharmacies don't know or heed the dangers of hot weather. Just this week I heard from someone whose insurance forces him to get his medications from a mail order service that refuses to ship insulin overnight or with any protection against temperature. This, even though the insulin manufacturer documented for this person that when insulin sits in a hot truck it dies. Meters and test strips can also become unusable if left in a hot car. I've cooked a whole vial of strips by leaving them on a car seat when it was in the 90s outside. The Science Daily article points out that even pills can be ruined by heat. That was new to me but I am no stranger to the phenomenon where one month's Metformin works a whole lot better than another's. Sadly, I am also no stranger to the phenomenon where when you complain to a pharmacy that your insulin is weak or there seems to be something wrong with your pills, they assure you it couldn't possibly be true and that no one else has complained about them. No one else probably has complained, because they probably assumed it was something in their own physiology that made their blood sugars suddenly shoot up. Given the vague way that most people with Type 2 are prescribed insulin and their lack of understanding of how insulin doses should correlate tightly with blood sugars, it is no surprise that customers pay for their insulin and accept whatever they're given, even if it barely works. Sadly, the problems caused by temperatur Continue reading >>

How To Manage Your Diabetes In Extreme Summer Heat
We often look forward to changes of season, but if you have diabetes , you need to be extra careful when temperatures climb dramatically. Extreme heat can affect your blood sugar control. Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy If you use insulin or if your treatment of blood sugars is inadequate, this can put you at higher risk. Often, worsening blood sugar control is the main concern. Depending on the situation and your level of physical activity, low blood sugars are also possible. Extreme temperatures can also damage your medications and testing equipment. I always remind my patients to take precautions to protect themselves and their supplies during both winter and summer. If a patient’s blood sugars are mostly higher than 250 mg/dl, I recommend improving blood sugar control before engaging in heavy physical activity — regardless of the climate and the temperature, as recommended by the American Diabetes Association. The extreme heat of summer affects blood sugar levels. How the heat affects your levels depends on what you’ve eaten, whether you’re well-hydrated and your activity level. If the heat and your activity make you sweat profusely, you may become dehydrated, leading to a rise in glucose levels. If you become dehydrated, your blood glucose levels will rise. This can lead to frequent urination, which then leads to further dehydration and even higher blood sugar levels — a kind of vicious cycle. Further, if the treatment includes insulin, dehydration reduces blood supply to the skin and, therefore, less absorption of injected insulin dosage. Most types of insulin can tolerate temperatures from 93 degrees F to 95 d Continue reading >>

How To Store Insulin
Insulin is measured in units. Most bottles, cartridges, and pens of insulin sold in the United States have 100 units of insulin per milliliter of fluid and are labeled U-100. Different strengths, like U-500, also are available in the U.S. Different strengths are used in other countries. It's important to know the type of insulin you take and whether it should appear cloudy or clear. When you prepare to use a bottle, cartridge, or pen, check the insulin: NPH should look uniformly cloudy after you gently roll the bottle or pen. All other insulin should look clear. If your insulin doesn't look right, don't use it. Take it back to your pharmacy. Don't shake your insulin. Gently roll it. Don't toss it around or handle it roughly. If you don't handle your insulin correctly, it's more likely to clump or frost. Don't use the insulin if you can see clumps after you gently roll the bottle or pen, or if the sides look frosted. Storage Guidelines Take steps to store your insulin correctly, or it might not work. Keep your insulin away from heat and light. Any insulin that you don't store in the refrigerator should be kept as cool as possible (between 56°F and 80°F.) Never let your insulin freeze. If your insulin freezes, don't use it, even after it's thawed. Keep unused bottles, cartridges, and pens of insulin in the refrigerator (between 36°F and 46°F). If stored properly, these will be good until the expiration date listed on the insulin. Keep insulin cartridges and pens that you're currently using at room temperature (between 56°F and 80°F.) Expiration Guidelines An open insulin bottle, cartridge, or pen is only good for a limited time. Follow these guidelines for discarding insulin: Glargine (Lantus): Discard opened bottles, pens, and cartridges 28 days after you've starte Continue reading >>