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Insulin going bad question

Discussion in 'Parents of Children with Type 1' started by Barry, Jun 1, 2010.

  1. Barry

    Barry Approved members

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    ketone strips, blood sugar strips, calibration strips....

    Anyone ever wonder why there is not a strip that measures the "freshness" of insulin. A strip you cound stick in your meter with a drop of insulin on it.

    Could it be that the companies that make insulin had rather you toss a bottle you suspect and open a new one$$$$$$$$$?

    Any pharmacists in here that know it to be impossible to develop because of the characteristics of insulin?

    Just wondering.

    Oh yeah, if there were such a strip, would you buy it?
     
    Last edited: Jun 1, 2010
  2. jilmarie

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    I wouldn't buy it. In my experience insulin going bad is a very very rare occurrence. I don't think I've ever had a vial of Novolog go bad.
     
  3. Barry

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    With a 17 yr old in a hot S Florida enviroment, we sometimes wonder when numbers dont make sense if it could be the insulin.

    Lots of out door activities where he carries his insulin for the day...in a cooler bag but lots of opening, forgetting to close.

    Every once in a while a used bottle mysteriously appears in his room, blah, blah.

    I called Nordisk one time to see how the effectivness "left" insulin...like a time table of effectiveness after the 30 days were up....they have those studies and will not release them....thought that to be strange.

    When unexplainable BGs go on for a couple of days, sites, illness, canula, and insulin all come to mind. I'd like to be able to rule out insulin.
     
  4. swellman

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    Neither have I seen a bad vial of insulin. Get him a Frio. As long as it stays room temp after openeing it's good for the month - you need to write the open date or the exp date on the bottle with a sharpie. The Frio does a great job keeping them at room temp - as long as it has a chance to breathe.

    Besides, you can't dip anything into a vial for microbial issues. I guess you could drip insulin onto a strip but I doubt the chemistry involved would be economically feasible. I would wager the test that the pharms use to test efficacy are involved and expensive. There just wouldn't be a sustainable market for a home test IMO.

    In our experience if something is going awry insulin is almost certainly the last thing we would suspect and if we did suspect it we would open a new vial.
     
  5. Scribe

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    i'm with jill. in 50 years of buying and using insulin (produced from pigs for years and now genetically engineered) i've never had a bad batch. never. i've also carried it with me unrefrigerated for long periods in places like iraq and new orleans. the stuff is really robust and doesn't require much (any?) special handling.
    if numbers are crazy, why not look to the obvious -- what are you eating? are you sick? are you getting any exercise?
     
  6. Barry

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    maybe I'm jaded. I have had my pharmacy tell me incorrect info, heard many diabetics (or parents of) that are misguided, and an in-person trip to a mail order house that many of us here use (used) revealed not even they were properly storing insulin 100% of the time. I always suspect the storage of insulin prior to being in my possession, and occassionally, my son's handling. I have to believe it degrades over time and not overnight and the "30 day rule" is when Nordisk determines it to be degraded to an unacceptable level. The fact that they tell me they have those day by day "going bad" numbers, but will not share them, makes me more curious.
     
  7. Barry

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    the obvious -- what are you eating? are you sick? are you getting any exercise?[/QUOTE]


    thats just it....none of the above....basals and boluses and currently being DOUBLED to stay in range...5 days now, around the clock, fasting, eating, makes no difference. 4 site changes.

    Fairly good chance all 3 bottles on refill have been handled the same way b4 I got them....thus the thought....It would be nice to rule out insulin
     
  8. emm142

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    Makes me wonder whether they have found that it lasts longer than 30 days, but want to keep people tied to buying every 30 days...
     
  9. swellman

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    In my experience, one with very close ties to someone in the pharmaceutical industry (Quality at the Director level), I have never heard of an expiry being placed on a product that is shorter than either required or necessary. In fact, pressure is usually in the opposite direction.
     
  10. swellman

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    If you have real concerns on how your insulin is stored prior to receipt I would suggest you look for a more reputable pharmacy.

    On the subject:

    In a private communication with a staff pharmacist at Novo Nordisk, I received the following message: ?If human insulin vials that are stored under refrigeration are used beyond 30 days, the stability of human insulin vials is dependent upon a number of factors in addition to temperature [sic]. These factors include the number of injections per day, volume of insulin remaining in the vial, exposure to light, agitation, and technique used for dose preparation. The impact of these factors is difficult to measure and the health professional should advise patients on an individual basis concerning long-term storage of opened insulin vials when refrigerated.?

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

     
  11. StillMamamia

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    Maybe a tougher puberty than usual?
     
  12. alleliz

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    I actually would love to be able to test insulin on something other than myself! I've recently had a few bad vials of insulin. I kept thinking that something else was the cause, but finally, I just started using insulin from a brand new 3-month supply (even though I had a couple vials of a prior 3-month shipment left). Magically, I didn't need the 140% temp basal anymore (I had been using that temp basal constantly for weeks-- I know, I should have set a new pattern, but that's not the point here!), corrections were finally working, and I was able to stay below 200 without much effort. I'm certain that the insulin was to blame. I'm also certain that a week or so before I had switched from one bad vial of insulin to another. They had all been stored in my refrigerator as they should be, but you never know what happened before it was delivered.
    The development of sensing devices is what I do in life, so this is actually something I've thought about a bit. I don't think I'd go with a test strip. I also think it would not be anywhere nearly as simple as glucose testing is.
     
  13. Barry

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    You make one, I will start the line to purchase.
     
  14. SarahKelly

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    My husband, t1d for 20 years, said he's never had a bottle of insulin go bad.
    Earlier this month Isaac's numbers were horribly high and even after several sight changes, new reservoirs and syringe shots we were seeing no changes. I decided it was the insulin and switched to a new bottle, within 2 hrs his numbers were down and have been more in range since. So, I am sure it was insulin (which was only 2 wks old and in the fridge). I felt bad that we put Isaac through several days of horribly high numbers, extra finger pokes, and sight changes just because of a bad vial of insulin. This is also the first time we've ever used a mail order pharmacy...so who knows.
    Our endo clinic has also told us several times that it is okay to have the insulin out and not refrigerated. This may be due to living in the pacific NW where our average temp is like that of an ice box!!!
     
  15. SarahKelly

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    So, I'd like to say that if they made some sort of way to know if it's the insulin we'd buy it. Well worth the money to not go through the days of guesswork.
     
  16. swellman

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    To those of you who go through mail-order ... is this by choice for reasons of cost? I ask because we have to go through Medco - mail order. When we get the insulin it's crazy packaged. It's in a huge bubble wrap/foam bag with several ice packs and it's shipped 2nd day - I think one could safely ship a baby in one if it could breathe. I have checked the temperature of the ice packs and they are always at least cool - not always cold but at least cool. I feel comfortable with their shipping however, as the OP mentioned, I have no idea how it's stored but this an insurance pharmacy so I can only assume they are in compliance with storage.
     
  17. SarahKelly

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    now that there are two people with t1d we do mail order for both sanity and cost. It too is packaged cold enough and safely enough for a little baby whale to make it here without issues :)
     
  18. Barry

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    I'd bet a carb free steak dinner that the technology exists. What does "the big insulin factory" do for quality control?? hold a gallon of insulin up to the light and look for crystals and cloudy? have "test diabetics" sitting around doing corrections before they release the batch? Oh, its out there.
     
  19. swellman

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    I found this in the USP: USP <121>

    The advent of practical yet sophisticated physiochemical methods (e.g. liquid chromatography) to measure insulin potency quantitatively has resulted in a more accurate and precise compendial test for insulin and insulin products. However, the bioidentity of insulin and insulin products cannot be assessed by these methods.

    I'm not sure if this implies that animal testing is required for final quality release but it does allude to the fact that there is Liquid Chromatography methods out there for potency. It's been a while since I was in a lab but it could very well look like this piece of equipment.

    [​IMG]
     
  20. Patzy

    Patzy New Member

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    Bad Insulin

    My son has been diagnosed with Type 1 since he was 3 (he is now 14). When we were getting humolog, we had some "bad" bottles. Not that often, but it did happen. Since we have been on Apidra, which our doctor says is a stronger, tougher insulin (?), we have not had a "bad" bottle. We never had a batch of bad bottles.
     

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