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How to avoid pain while injecting the insulin injection ?

Discussion in 'Type 1 Diabetes' started by Chandradev819, Jun 1, 2016.

  1. PseudoBob77

    PseudoBob77 Type 1 · Well-Known Member

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    I don't read instructions lol. So why am i taking insulin to work in a cool pack then, and why do they sell them.

    So it's unopened you have to keep refrigerated, as it says on the box. I always thought it had to be kept chilled.

    Sent from my SM-G900F using Diabetes.co.uk Forum mobile app
     
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  2. PseudoBob77

    PseudoBob77 Type 1 · Well-Known Member

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    Insulin potency
    Potency is the effectiveness of insulin to lower blood glucose. Potency
    decreases with exposure to light, temperature and vibration, so
    correct storage of your insulin is important. In-use insulin not stored
    in the fridge has been exposed to all these factors so its potency may
    be reduced and this is why it should be discarded after 28 days [less
    with certain insulins].
    The following facts are known [ref1]
    • The potency of insulin decreases very gradually over time and the
    degree of reduction depends on the storage conditions.
    • Insulin should be stored in the dark as exposure to sunlight
    decreases its biological activity. The optimum storage is in the dark
    at temperatures between 2 and 8°C. Freezing must be avoided as
    it can destroy the insulin.
    • If there is a loss of potency as a result of storage at high temperatures
    for long periods, then the breakdown products of insulin are not
    harmful in any way - unlike expired antibiotics, for example. So the
    insulin is safe to use but it may not be fully effective.
    The table below shows the extremely long periods of time before the
    potency is reduced by even small amounts – no similar figures are
    available for analogue insulins.
    Time of storage of insulin preparations at various temperatures
    until biological potency is reduced by 2% and 5% respectively
    Insulin
    preparation
    4°C 15°C 25°C 40°C
    Actrapid 36/92 years 5/13 years 12/31
    months
    5/14 weeks
    Semilente 45/115
    years
    4/11 years 7/18
    months
    2/5 weeks
    Lente 36/91 years 3/9 years 5/14
    months
    1/ 4 weeks
    Rapitard 22/55 years 3/8 years 7/17
    months
    3/7 weeks
    Ultralente 19/48 years 2/5 years 4/10
    months
    1/3 weeks

    Information source: ‘Galenics of Insulin’ by J Brange M.Sc et al: [Novo


    Sent from my SM-G900F using Diabetes.co.uk Forum mobile app
     
  3. catapillar

    catapillar Type 1 · Well-Known Member

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    It's funny isn't it, sometimes the things you have thought to be the case because that's how you've always done them can turn out to be wrong - I think you are taking insulin to work in a cool pack unnecessarily & you probably should have a quick flick through the instruction leaflet, just in case!

    Also, your quote in post #22 re potency, says that it's fine for 28 days. I mean the table at the bottom hasn't worked, but I'm guessing that says no reduction in potency for temperatures up to 25 degrees for up to 4 weeks? I can't afford to keep my heating up that high, so I'm confident my insulin is fine :)
     
  4. PseudoBob77

    PseudoBob77 Type 1 · Well-Known Member

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    The higher the average temperature it is kept at the less effective it will be as the insulin breaks down biologically. On the contrary where in any medical information does keeping insulin chilled once in use have a negative effect, there is no information that actually states that keeping insulin chilled when in use impairs the products lifespan.

    Sent from my SM-G900F using Diabetes.co.uk Forum mobile app
     
  5. catapillar

    catapillar Type 1 · Well-Known Member

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    I don't think it does say that in the leaflet in with your insulin because they are designed to be a quick reference guide for people to easily refer to so they know what the manufacturers instruction are on how to use the product. I know my novorapid leaflet says: a pen that is in use "is not to be kept in the refrigerator" that was good enough for me, I didn't think to question it much further. Not least because injecting cold insulin is uncomfortable so I'm happy to avoid that.

    I think what has been said in this thread (not by me, so I'm not entirely sure) is not so much that cold insulin is less potent or has a reduced life span, but more that cold insulin had a delayed action when compared to room temperature insulin. I don't know where that comes from in terms of medical literature, but I can see the logic to it - I mean insulin is going to want to be body temperature before it starts doing anything useful to your blood sugar right? Makes sense to me.
     
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  6. Expat in Turkey

    Expat in Turkey Type 2 · Member

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    Hi,

    As my moniker suggests I live in Turkey. I was told to ALWAYS keep insulin in the fridge. Maybe this is because the average temperature is way higher than in UK. Today it touched 41C which is HOT. At night it is 30C+ Of course the house is air conditioned...

    I don't have a problem with my Nova Rapide injections, they are less than 20 units. Of course if I hit a nerve it hurts! but I will just pull it out and find a fresh site. I use straight from the fridge and sometimes it burns a little but really no problem.

    The evening injection of Lantus is different. It is larger - typically 50 units and if I inject it cold into a single site it hurts like hell! So I let the pen warm up for 15 - 20 mins and split the injection over two sites (2 separate injections) This works for me. Of course after the injections it is back in the fridge.

    Experiment a little some sites are more sensitive than others. Injecting yourself 4 -5 times a day soon banishes any needle squeamishness. Find out what works for you.
    .
     
  7. Humma

    Humma Type 1 · Well-Known Member

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    There is no pain now...... i first injected age 13 October 1968 almost 48 years ago with a metal and glass syringe and metal needles now 48 years ahead i inject up to 10 times a day with no pain at all
     
  8. Kristin251

    Kristin251 LADA · Expert

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    I couldn't imagine not pinching the skin. I pinch, inject and then let the skin go and hold it in for 5-10 seconds. On a rare occasion it hurts but doesn't kill me.
     
  9. PD Oz

    PD Oz Type 1 · Well-Known Member

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    Always go room temperature. Also very important to rotate site from side to side alternatively and in a rough 360 circle every time. I prefer on the stomach under the belly button line and no closer than 5cm to the belly button. If using a fine tip pen needle try and go straight in at 90deg. I try to avoid pinching up the skin too tightly or unevenly. When I select a site and get the loaded dose and needle tip close I will then let my eyes unfocus and not look directly at the needle going in. 99 times out of a 100, I barely feel anything. Once I got a nasty sting but I think I got too close to an appendectomy operation scar, so I avoid that zone. I changed to a 4mm from 6mm tip after getting good advice on this forum. Much better outcomes, far less stings and virtually no incidents of getting small bleeds after the needle tip removing tip.
     
  10. cally49

    cally49 · Newbie

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    Although I am a type 2, I have been injecting since 2000. I experienced discomfort at first when I was given 30 gauge needles.
    Moving to 8mm 31 gauge proved beneficial. The finer needle does much less tissue damage and avoids skin thickening.
    Injecting slowly and leaving the needle in for a count of ten allows the insulin to disperse. I also use surgical soap daily when washing injection sites which prevents infection which can also be a cause of pain. The result, 16 years of trouble free injecting.
     
  11. Mariemccann

    Mariemccann Type 1 · Member

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    its all trial and error I find. sometimes it stings when I inject but carry on regardless!!
     
  12. Daibell

    Daibell LADA · Master

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    Hi. I can only add to other comments that you should read the leaflet that came with the insulin or download it from the web. This 'always' says to keep unused pens/cartridges in the fridge but not any pen in use. The leaflet lists the temperatures for storage and use. You mention a bottle? Are you using both pens and a vial? If so any reason why you don't use pens for everything? I think vials always have to be kept in the fridge?
     
  13. Incidentals

    Incidentals Type 2 · Member

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    I see no-one has suggested the safety needles, these hurt less because they suddenly put the needle in and the time to worry about the pain is away before you can really think about it!... that sounds odd I know but it seems to be true. When my 3 year old bestest nurse uses the safety needles I feel less than when I inject myself and that is for any site.

    I rotate all my sites and find the bottom is particularly immune to the needle as are the tops of the flabby bits of arm and as one of the respondents has already mentioned if you feel the tip of the needle as "too sharp" simply move a little to the side until you don't and continue from there.

    It burns when its cold and it burns when injected into muscle other than that it is much less painful than most people think.

    I am so glad we can use tiny 4 and 5 mm skinny needles rather than the 25 mm thick needles my mother started with aged 14 that she had to hone sharp with a whetstone - I still have them as a reminder of the suffering she endured just to be there for her family.
     
  14. Jordi77

    Jordi77 Type 2 · Well-Known Member

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    The way I do it and always have is to use the novopen 5 out of the fridge and the spare cartridge in room temperature and the rest of the cartridge's in the fridge and when I have finished the cartridge in the pen and put the spare one in to go to the fridge and get the next one and put that in the case so that it goes to room temperature and then if I have problems with the cartridge in the pen I can change it and I can throw away the other one and if not I have the next one ready to use when I need it at room temperature
     
  15. Deleted Account

    Deleted Account · Guest

    When I used a pen, I would always keep my pen out of the fridge. If I was travelling somewhere hot, I would use Frio packs: not to refrigerate the insulin but to stop it getting hot.

    Now I have a pump. The insulin in the pump is out of the fridge. I have not been anywhere hot enough with my pump to worry about the insulin getting too hot but I have seen pump Frio patches if necessary (although they look huge). I also keep my "top up" vial out of the fridge. Two reasons for this: it is not cold when I need to change my pump set; I carry the vial and a small syringe with me when I am out in case there is a problem with the pump so I have a short term alternative.
     
  16. CHIET1

    CHIET1 Type 1.5 · Well-Known Member

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    I have always stored my insulin in use and also unused insulin in the fridge, which is normally at 3-5 C

    Sometimes it can sting, but doesn't happen me very often. I also use 8mm, because I found that I lost more insulin when injecting using 5mm. I pinch the skin either in the area below the belly button on both sides or the skin along the side of my upper torso. Then I try to jab the needle as fast as I can, I find this is much less painful than inserting the needle slowly. It takes a few goes to get over the fear, but it really doesn't hurt if you insert it quickly.
     
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  17. amey_13

    amey_13 Type 2 · Member

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    I'm definitely gonna try that...!
     
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  18. amey_13

    amey_13 Type 2 · Member

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    If you use the safety needles on the Insulin Pens they jab in quickly anyway, so I think this is very good advice (still stings a little tho)
     
  19. Glucobabu

    Glucobabu Type 1 · Well-Known Member

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    What do you do when you are holidaying in a tropical country or even in the Mediterranean? You can't leave your insulin pens in use at 'room temperature' which can be into 30s C. And I have found using Frio bags continuously in tropics markes them go mouldy! When I am on holiday I stick it all in the fridge, away from the freezer compartment. Atleast this ensures the insulin doesn't go off. I think the reason given for storing pens at room temperature might be the effect of low temperature on the pen mechanism which might affect the accuracy of dose delivery? If I am out for the day I use Frio bag which keeps it cool for the whole day. Talking about Frio bag, you can't simply dump it into your ruck sack. It has to be exposed to air to work. I hook it on to the bag strap with a safety pin and make sure it doesn't dry out. As for the pain while injecting, pinching up the skin very slightly and injecting straight down at 90 degrees seems to help but sometimes you still get the 'burn' whether the insulin is at room temperature or not!
     
  20. Ledzeptt

    Ledzeptt Type 3c · Well-Known Member

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    I've been following @Flakey Bake's scratching tip for several months since I first read the suggestion and found it works for me - thanks Flakey :)
     
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