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Insulin Losing its Potency real fast

Discussion in 'Parents of Children with Type 1' started by NomadIvy, Jul 22, 2010.

  1. NomadIvy

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    Everytime we go out to swim or do anything, I keep the insulin surrounded by ice packs. The pen is usually in an insulated bottle pack with several small frozen gel packs in them. Oh, it's really hot here right now, it's in the 90s (F) / mid 30s (C).

    Next day, ~K's usually running high. I'm thinking it's the insulin, because no matter how many times I correct, her numbers barely budge.

    I know I'm not supposed to keep the insulin exposed to very high heat. But it's surrounded by ice packs, inside an insulated pack, inside a lunch box (also insulated).

    Or... is keeping the insulin in cold temp, then in room temp making it go bad? I've been changing vials in the pen every 6 days. At the rate we're going, her one year supply won't last us a year!

    Any thoughts?

    Thanks.
     
  2. BCmom

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    I don't have an answer for you but look forward to the answers, because I have wondered about it too.

    BTW is it the Lantus or the Novolog or both?
     
  3. NomadIvy

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    The novolog.
    Hmm... why are you up? :)
     
  4. Mistync991

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    keeping it too cold can affect it as well ..with it right next to the ice packs it could be that

    here is what i do with my insulin or dd's pump going to the pool/beach...
    i put them in an insulated bag with a washcloth seperating them from an ice pack and often toss that in the top of the cooler

    i have done this before for short trips but also did this the entire week of the forth when we went to the beach..and by beach i mean thats it you go to the beach all day or to the pool ..now i think the longest we stayed out there at one time was 5 or 6 hours but the icepack was still cool when we got back

    sometimes i do toss a bottle drink in there as well to keep it cool to drink later or i may use a frozen drink instead of a ice pack

    now if you want to get fancy you can always order a frio pack they work wonders i hear

    hope that helps
     
  5. kiwiliz

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    I have read of an experiment where novorapid was kept in a shirt pocket for one year - and was perfectly fine after that time (so that is at body temp around 36'C).

    This references a similar study
    http://www.medicalcorps.org/insulin-storage.htm
    The group medicalcorps, of which I have no affiliation, appears very qualified.
     
  6. canadianmomto6

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    Is there any chance your daughter is going low through the night due to the swimming and what you are seeing the next day is rebound numbers? Just a thought because I know swimming and hot weather can make Liam drop several hours later.
     
  7. NomadIvy

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    I check her every two hours at night...so, no, I don't think it's a rebound.
     
  8. Lee

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    It is probably freezing with the ice pack. I actually put mine in a tupperware container wrapped in a wash rag, and then put that in another tupperware with the ice pack.

    I would try something like that, or even just the wash rag as my first troubleshooting step.
     
  9. McKenna'smom

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    I don't know if FRIO Packs are available where you are, but they are pouches that you put in water and then they use evaporation to keep the insulin pens at a safe temperature.

    http://www.friouk.com/
     
  10. Heather(CA)

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    If she is running high the night/day after swimming and staying high with corrections. I don't think it's the insulin, it sounds like either adrenaline highs or rebounds to me. Adrenaline highs are basically rebounds without the lows...

    There are a couple of things you need to do. test test test over night so you can catch the low, once you know...Give less insulin at dinner after swimming. And, stop correcting, it's only keeping her high. See if she comes down on her own...During the day you can correct but not a full correction. Have her eat something, then add up what you would normally give her and subtract 1 unit. Works like a charm;)

    Trust me.

    If for some reason it is the insulin which I doubt. Ice packs could be the problem wrap the insulin in a small towel and keep it with cold packs, not actual ice. Insulin can be sensitive to both heat and cold, it's not supposed to freeze... :)
     
  11. Christopher

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    This goes against everything I have ever read, heard or seen about the proper, safe storage and handling of insulin.
     
  12. sarahspins

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    I agree, and it's slightly irrelevent anyways since I would presume that relatively few diabetics these days use Humulin... the analogs definitely seem to be more sensitive to temperature changes.
     
  13. kiwiliz

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    It is the only experiment that I have read about that was even near relevant. I completely agree that we cannot guess about the integrity of insulin but the only way it seems to test whether it still works is to use it, or if it looks cloudy. I guess that if insulin is held against your body, as in a shirt pocket, your body is going to regulate the temperature to a certain extent. If anyone else can find any studies done I would also be extremely interested. A study would be better than an opinion.
     
  14. badshoe

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    Well I for one want the insulin properly stored and handled. I expect the mail order pharmacy to deliver it in the safe temperature ranges the manufacturer specified to the FDA. I had a firm try to say it was OK to ship it in un cooled packaging via ground carrier in an August heatwave. In side of the trucks had to be real hot.

    They had a study too. I'm sticking with documents filed with FDA.

    To the OP. I would first try cool not cold storage. My kids don't like cold insulin they say it hurts. But I doubt it got too cold either.

    Lots of things impact blood numbers. It may not be the insulin. I was just reading an article about highs after activity. I have no clue of that is your issue but I bring it up to point out that it is just part of the diabetes game to be confused.

    Best of luck
     
  15. kiwiliz

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    Results of a study funded by Novo Nordisk
    http://www.schererclin.com/Intro_To_Insulin.pdf

    Table 4. Recommendations for Storage of Insulin
    Analogs After First Use.​
    Product/Formulation Days at Room Temperature​
    NovoLog (vials) 28 also refrigerated
    NovoLog (PenFill​
    ?

    cartridges, FlexPen) 28
    Humalog (vials) 28 also refrigerated
    Humalog (cartridges, pen) 28
    Humalog Mix75/25 (vials) 28 also refrigerated
    Humalog Mix75/25 (pen) 10
    NovoLog Mix 70/30 (FlexPen
    and PenFill cartridges) 14
    NovoLog Mix 70/30 (vials) 28
    Apidra (vials) 28 also refrigerated
    Lantus (vials, cartridge) 28 also refrigerated
    Levemir (vials, cartridge, 42​
    FlexPen)

    Storing Insulin Analogs and Premixed
    Insulin Analogs​
    Each vial, cartridge, and insulin-containing component
    of an insulin delivery system (prefilled disposable) has an
    expiration date and should not be used after that date.
    Once the expiration date has passed, the insulin may begin
    to lose potency and, if used, may not provide reliable
    control of blood glucose levels.
    Unopened insulin containers should be stored in the
    refrigerator at 36​
    oF to 46oF until the expiration date. If
    unopened containers are stored at room temperature,
    expiration time is the same as an opened container
    (Table 4). Patients should NOT store insulin in the freezer,
    as freezing may alter the consistency of the formulation.
    The insulin that is currently in use (eg, open insulin vials,
    cartridges, or prefilled pens) should be kept at room
    temperature away from heat and sunlight; the ADA
    recommends avoiding extreme temperatures. Storage
    recommendations for vials, insulin cartridges, and prefilled
    pens, after puncture or first use, are shown in Table 4.
    If frosting (little white flecks that adhere to the inside
    of the container above the surface of the solution),
    clumping (aggregates of insulin remain after mixing), or
    discoloration appears, the container should be discarded.
    Although premixed insulin analog preparations are
    cloudy, rapid- and long-acting insulin analog preparations
    should always appear clear. Any rapid- or long-acting
    insulin analog product containing cloudy or discolored
    contents should be discarded. If there is any question
    about potency, the safest step is to discard such insulin.
    Unexplained hyperglycemia after using insulin that
    has been exposed to extremes is probably the result of
    diminished potency. In such cases, the product should be discarded.
     
  16. wilf

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    Ok, so this flies in the face of all information being provided to parents of children with D in both North America and Europe..

    I would disagree based upon our own experiences. We had insulin get very cold (down to freezing temps, without freezing) and it was shot.

    My concern is that you may be over-cooling your insulin..
     

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