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Bad insulin vial

Discussion in 'Insulin Pump Forum' started by chrisopher, Apr 22, 2013.

  1. chrisopher

    chrisopher Member

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    Hi everyone.

    I'll try to keep this short. I've just made the conclusion that I was using a bad insulin vial which I realize is very unusual. I am using novorapid and had unexplained high blood sugar levels for a few days. Firstly I put it down to stress, then I changed my cannula, then the reservoir itself. I then decided to increase my overall basal rates by 25% and I was still getting high blood sugar. By this stage, I was getting really stressed out which can't have helped matters. Finally, in desperation really, I started using a new insulin vial (same batch I think) and my blood sugar levels became much more normal.

    I've been a diabetic for six years and been on a pump for about six months. I've had maybe two longish periods that were similar to this one where my blood sugar levels were difficult to control and I'm wondering whether bad insulin could have explained those times as well. In future, when I start to notice a pattern of high blood sugar levels, I think I will definitely consider bad insulin as a possibility. For the record, the insulin was having an effect but was not nearly as effective as it should have been.
  2. glenmoray

    glenmoray Member

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    I to am using Nova Rapid as a basal bolus injection. Ever so often I get unexplained high blood sugars which last for 2 to 3 days. I to feel that occasionally I get a bad vial of insulin but no one seems to take what I say serious. I don't know how my insulin has been kept before I have received it. ive noticed the delivery vans that deliver to the pharmacy a have no fridge compartments to keep the insulin cold during transit on hot summer days. I know you can get temperatures in excess of 100 degrees in summer. I think your right about bad vials.


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  3. donnellysdogs

    donnellysdogs Forum Regular

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    I think its our bodies myself... Changes occur regularly to me and Normally I put this down to heat/cold, changing from root veg dinners... Now to salads...,hormones, activities.. Is it holidays, is it working, is it weekend, is it going out with friends?

    I started off on 18 units basal per day, this can go down as low as 12 during the summer. I been on pump almost 3 years.

    However..... You should make sure you have a thermometer in your fridge.. As it is easy for them to be at wrong temperature... Especially Beko ones.

    Also if you are convinced its the insulin, then you should be informing the mhra of the detsils, so they can check it out officially....
  4. skipbifferty

    skipbifferty Member

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    (Previously I posted under 'chrisopher').
    I am still 99 percent sure there is a problem with the insulin. The new vial I put in worked initially and then, after about a day, my bad blood sugar levels returned. I then went on to a completely new supply of Novorapid pens and I haven't had a blood sugar problem for 4 days since! I've just informed the mhra.
  5. donnellysdogs

    donnellysdogs Forum Regular

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    Have you got the batch/manufacturing lot number that you could pist on here... If others then have the same lot/manufactured batch they could also monitor their insulin?
    Dont know if you are allowed to say what Pharmacy ie Boots, lloyds or independent, so that we could also check whether we get same orobs with insulin when prescribed from these pharmacys.
  6. snufflebabe

    snufflebabe Member

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    Hi I totally get where you are coming from, as every so often i have higher than normal blood sugars, where i change cannula and resevior, and nothing changes till i use a brand new vial of insulin, I reckon the pharmacy doesnt store them properly. I thought it was just me who thought the vials were bad. I told my DSN and i think she thought i was making it up. its not my fridge as it has a digital thermometer, and besides if it was that all the other insulin would have been bad. Nextime i will report it, now i have read who you go to.
  7. skipbifferty

    skipbifferty Member

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    That's exactly how most people react Snufflebabe. I am even nearer to being 100% sure because I've eliminated the cannula sets and sites as possible problems. Apart from the insulin, the only other possible answer could be the reservoirs, but that seems very unlikely to me. I won't say I'm 100% sure until I've checked the original resesrvoirs I was using (I'll do that in a few days). In the meantime, and since I haven't heard back from the mhra I can tell you that the batch number is BS6A256 and they expire 12/2014. I got them from an independent pharmacy in Salusbury Rd, Queens Park, London. There are 2 on that road and I think the insulin came from both of them (because they are co-owned and I had to go back for the rest of my order). It could as easily have been my fault rather than the pharmacy's but I think it's probably unlikely to have been a manufacturing problem. Anyway, if you have insulin with this batch number, keep an eye on your sugar levels just incase something's wrong with it.
  8. iHs

    iHs Well-Known Member

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    Hi

    Where temperature storage problems might be suspected, it might not be the fault of the pharmacy but the fault of the wholesaler that supplies the pharmacy.

    Pumps do play up though and at times its difficult to know exactly what is causing what... Increasing basal rates up doing a TBR wont always work whereas increasing the hourly basal rate does. Its just knowing how much to increase the hourly basal rate up by but as long as bg testing can be done, the worst that is going to happen is a low bg level and that can be sorted by eating some carb. Also, its not that uncommon for bg to change sometimes just for a few days and then bg reverts back so basal rate changes then need to be altered back to before they were changed.

    Thank goodness for bg teststrips.... without them we'd be sunk...
  9. Robinredbreast

    Robinredbreast Moderator

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    Scary, isn't it? Hi, I too have been going through highs the past few days and my Insulin is NovoRapid and Levemir. I eat a varied and well balanced diet, I'm not unwell, still doing exactly the same as I always do (a creature of habit) and some of the readings I have had have been unbelievable. I have had practically constant highs and last night, another high, this one was 13.5, I took my usual levemir and also took NovoRapid ( this was recommended by the hospital DSN) and this morning BS was over 18 before breakfast :shock: :shock: :? Also 99% of the time my BS reading before lunch is normally very good, but lately so high. I have changed NovoRapid vials and now the Levemir pen ( disposable)

    Today the readings have been slightly better, but I'm not holding my breath. I did wonder if it was me, but I could not find anything that may have contributed to the highs so.................What is it with NovoRapid ?

    I will do the same as you, if I start to notice unexplained highs in the future, oh, forgot to say I am on injections only, not pump.

    All the best RRB
    I'm crossing everything for tonight's reading.
  10. skipbifferty

    skipbifferty Member

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    Hi, I have to say that I've been using novorapid for over 6 years, mostly pens, and this is the first time I've definitely had a problem so it's very rare in my limited experience. Faulty insulin was the last answer I considered, after first trying different body sites and cannulas (and, unnecessarily I think, the reservoirs), and it probably will be in future, but I'll definitely never exclude it. Do you use novorapid vials with disposable syringes, why not simply the pens?
  11. Robinredbreast

    Robinredbreast Moderator

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    I use cartridges in my NovoRapid pen, its my Levemir pens that are disposable, once finished with, then throw away.

    Actually, I think NovoRapid has come up before regarding possible faulty vials.

    Best wishes RRB
  12. chrisopher

    chrisopher Member

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    Update: Sent vials to medtronic (the mhra contacted them) who sent them to Norway for testing. They say they'll keep me updated.
  13. deejayCarman

    deejayCarman Member

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    My son became diabetic 29 years ago. He used NPH and Regular. Both were very dependable and the last injection out of the bottles worked as consistently and exactly as the first injection drawn out of a fresh bottle. There was not a requirement at that time to "discard the unused portion of insulin after 28 days"---in fact, sometimes we would accidentally end up with 2 bottles of Regular or 2 bottles of NPH open. As young as he was, with the tiny dosages he needed, meant that the extra opened bottle might have been in the fridge for 3 months before it was used up....but even being opened this long, it worked consistently and was as strong as the first injection out of a freshly opened bottle. Now days, however, during the past 3 years, it seems the lasting ability of the opened insulin has gone down hill drastically. After about 2 weeks of being opened, his Humalog and his Levemir both start to progressively weaken in strength, requiring him to increase his dosage. He often has to throw the unused portion of the bottles away 21 days after opening. Our refrigerator is good, and very cool, but never so cold as to freeze the insulin. I wonder what happened to the quality control of insulin. I wonder why the old insulin, (Regular and NPH, that cost only $20.00 per bottle back in the 1980's) lasted for over 4 months after opening and worked as consistently and dependably as insulin from a brand new bottle. What is this degrading factor that affects these $180.00 bottles of insulins that are sold to us now?
  14. skipbifferty

    skipbifferty Member

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    Well, I've had an update from Novo Nordisk. It sounds like they did thorough tests and it came back all clear on the unopened vials that I sent them. Of course, I've since found out that some of my medtronic reservoirs were leaking so that could have been the problem all along but I'm still not sure. I think that at least one of the vials which I was using had a problem but that's all I can say for sure.

    Deejaycarmen, I'm not sure what's the problem in your case? It doesn't really sound like the same issue because mine was a rather sudden problem, not one that took about 2 weeks to appear and only then started to progress in intensity. I think I started to encounter problems after only a few days after the insuling was out of the fridge. At least I have the medtronic reservoir problem which I can blame and which definitely affected me to some extent (see my other posts). At least, novo nordisk was excellent in examining them problem and getting back to me on the results so I can't fault them at all really. The lesson I've learnt in all this is that it's difficult to test your blood sugar level too many times and go with your heart!
  15. Fi2508

    Fi2508 Member

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    A couple of months ago my hba1c had risen and I couldn't understand why as I hadn't changed anything. However I had noticed that my daily bloods sugars were regularly on the high side despite taking correction doses. I contacted my diabetes nurse and she advised me that Medtronic were doing a recall on certain reservoir batches. When I got home I checked my reservoirs and my last delivery were part of a recall batch. As soon as I changed to a safe batch my bloods lowered and my hba1c is back on track.


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