Insulin no longer working as effectively

[Miniman76]

I've noticed sometimes either my lantus or novarapid Pens stop working as effectively when lowering my sugar levels. It's usually when I'm down to my last packet but there is still alot of time left on the use by date? I throw then insulin out and get new stuff and it fixes the problem. My question is how reliable are the use by dates on insulin and is there another cause of the effectiveness and I'm being psychosymptomatic

Thanks

 

[porl69]

I've noticed sometimes either my lantus or novarapid Pens stop working as effectively when lowering my sugar levels. It's usually when I'm down to my last packet but there is still alot of time left on the use by date? I throw then insulin out and get new stuff and it fixes the problem. My question is how reliable are the use by dates on insulin and is there another cause of the effectiveness and I'm being psychosymptomatic

Thanks

How are you storing your insulin?

 

[Juicyj]

Hi @Miniman76

Insulin out of the fridge needs to be used within the month - in regards to storing it here's some useful info:

• To ensure that your insulin remains effective, stable and undamaged you should discard your ‘in use’ insulin after 28 days, whether in a vial or cartridge.
• Insulin that is not in use should be stored in the refrigerator. If refrigeration is not possible, it can be kept at room temperature [15-25 degrees C] for 28 days.
• The in use vial may be kept at room temperature [15-25 degrees C] for 28 days.
• In use cartridges should be kept at room temperature and SHOULD NOT be kept in the refrigerator.
• Insulin has a ‘use by’ date as well as an expiry date.

 

[Antje77]

Have you checked the temperature in your fridge?

 

[Circuspony]

I have just thrown away 2 x cartridges of Tresiba that had been stored in the fridge - and yes, the temperature is fine.

I couldn't understand why my overnight levels suddenly rocketed. Went through all the usual scenarios over the course of last week then remembered I'd recently changed cartridge. Changed to one from a new untouched packet and within 24 hours all is fine.

I do remember a nurse telling me when I was first diagnosed that you can't always guarantee that they've been correctly stored at the pharmacy and other places along the supply chain so on that basis I threw out the remaining cartridge in that packet too. Not risking it. Also very grateful I'm not in a country where I have to pay for it.

 

[Antje77]

Do you keep it in the fridge door? Temperature in the door changes much more than in the body of the fridge from opening and closing it.

 

[Miniman76]

How are you storing your insulin?

I keep it in the back of the fridge

 

[NicoleC1971]

I keep it in the back of the fridge

Other things to consider would be:
weight gain? This would necessitate more insulin especially if you've gained fat rather than muscle.
Less muscle + less insulin sensitivity
Any lumps and bumps caused by injecting in the same spots? Get a nurse to check. I had this issue and didn't realise it but this would affect absorption. You inject insulin in the same spot and it creates a very local fatty lump.
Are you increasing doses and if so are you injecting nice and slowly? If you push the plunger down too fast lots of the insulin will not go in.

 

[Miniman76]

Other things to consider would be:
weight gain? This would necessitate more insulin especially if you've gained fat rather than muscle.
Less muscle + less insulin sensitivity
Any lumps and bumps caused by injecting in the same spots? Get a nurse to check. I had this issue and didn't realise it but this would affect absorption. You inject insulin in the same spot and it creates a very local fatty lump.
Are you increasing doses and if so are you injecting nice and slowly? If you push the plunger down too fast lots of the insulin will not go in.

Thanks for the reply.

1.havent gained/ lossed any more then 1kg
2. I regularly rotated sites around my thighs for insulin
3. Max insulin I have at any one time is about 11 mlU

Thanks

 

[NicoleC1971]

Thanks for the reply.

1.havent gained/ lossed any more then 1kg
2. I regularly rotated sites around my thighs for insulin
3. Max insulin I have at any one time is about 11 mlU

Thanks

So 11 mlU is a fair amount so if it were me (and it was before I became a low carb/low insulin pumper) I'd get someone to check for lumpage and jab technique including using fresh needles.

 

[scotteric]

Thanks for the reply.

1.havent gained/ lossed any more then 1kg
2. I regularly rotated sites around my thighs for insulin
3. Max insulin I have at any one time is about 11 mlU

Thanks

Have you tried another insulin? Sometimes the immune system can stop a certain insulin from working properly, but another one might work fine. Sometimes even Regular insulin (sold under brand names Actrapid, Novolin Toronto or R, Humulin R or S, etc.) works better for people having immune reactions to insulin analogues.

 

[Daibell]

I find I have to increase my Basal if I've had a lot of carbs and my BS average that day has been higher than usual. I gather this is a common effect. Similarly for my Bolus ratio. Insulin needs do not vary in a linear fashion with carb intake.

 

[Miniman76]

So 11 mlU is a fair amount so if it were me (and it was before I became a low carb/low insulin pumper) I'd get someone to check for lumpage and jab technique including using fresh needles.

11 mlU is only for a large bowl of pasta or something extremely carby. It's not an everyday occurrence.

 

[SueJB]

My question is how reliable are the use by dates on insulin and is there another cause of the effectiveness and I'm being psychosymptomatic

Hi @Miniman, I think the dates are reliable and lots of the others have given you other ideas on its relative effectiveness. It happens to me and likeyou I stor insulin well, in the salad box for me and I rotate pricking sites.
I just reckon it's one of those things, @scotteric may have a point too

 

[karen8967]

I used to be on apidra for bolus insulin and i found over time it became less effective i am now on fiasp and find this much better although i do think that near the end of my val the insulin does seem less effective although still in date and not 28 days old

 

[SugarBuzz]

I've used insulin that's spent some months out of the fridge in the past

Though I guess when you've had to pay 45e for 4 weeks supply in the past (and probably will have to again), you kind of have 2nd thoughts about throwing any of it away.