I brought a chemists fridge for £500

[JonnyS31]

Hi,
I would like to consult all you experienced diabetics on what I think is a faulty/denatured insulin straight from the chemist.
I have been on Novorapid and Levemir for around 2 years, coming from the older styles insulins it was a great! I lost a belly I'd had since diagnosis, felt good and had everything under control.
For the past year and a half I've had troubles with what i can only put down to faulty insulins,
I think I know about the variables involves in controlling MY BS and explore every avenue before making the assumption that this is a bad "batch" (but we know this takes days sometimes weeks of ill feelin) then march into the chemist demanding they do something about it, believe me i feel soo bad I'm not tactile by this point.
when this is happening my BG seems to run around 7-8 I waking at 10-18 a bad start to everyday, it is possible to lower and hypo using large sometimes scary doses but very unstable and can creep up many hours later I always have a high feelin - thirsty hungry general restlessness and nervous for no reason, like a over-glucosed sickness I felt for around 25% of the past year.
Hopefully I go to chemist get a new batch and all is fine and well BS around 5-7 waking (when I'm good :wink at 5-7 with a happy well being, the diabetes make sense as much as it ever can 8).
I've always blamed the chemist so 3 months ago i spoke to another chemist AND the receptionist in my doctors (where my original chemist - Boots (Edited) is located) they said its not the first time they heard it from customers using Boots. Fantastic I thought Bad insulin problem solved! so I changed my chemist my who told me they receive the insulin staight from Nordisk (the manufacturer) For the last two months/batches its been happy days but receiving a new batch on 22nd of November I now feel and am testing in the same way as before.

Any theories however wild would be appreciated. I out of ideas..

 

[HLW]

Novorapid lasts 4 weeks room temp, levemir 6 weeks so even if their fridge is faulty I don't think they will have it sitting around for that long, unless they have poor stock rotation but I really doubt that would happen in a chemists.
If you are waking high, and can treat the high blood sugars Ok with novorapid (its very rapid, hence the name, and only lasts a short time, so your blood sugars will rise a few hours later if eg you eat low GI something and inject novorapid, you might still be digesting the carbs one the novorapid has worn off?), then is the problem with levemir? Maybe lantus would suit you better, have you asked your diabetes team about it? It might be fewer injections too, it lasts longer than levemir.

 

[JonnyS31]

Hi HLW,
Thanks for the quick reply, I was thinking the problem was more a faulty fridge in the van or lazy delivery driver it can get hot in the back of a van, changing from Boots to Lloyds has put the blow that theory a little. I cant keep the bg ok they head up,the same foods intake seems to last longer pushing the sugar levels higher. My novorapid should and does 75% of the time last about 4 hours peaking about 2-3hours then the levemir carries nicey til the next food. I thinking of asking the diabetic team for a change a selection of all would be good ! Have you heard anything about 3 doses of levemir a day?

 

[sugar2]

Hmmmm. Well, the only problem I have had with insulin from Boots was when they gave me out of date stuff..so alas, I am not so confident of their stock rotation.I completely accept that sometimes there are bad batches etc but for it to happen often, and with the change of chemists, hopefully ruling out storage conditions, I would suggest that this is not the issue?

Do your periods of needing more insulin coincide with anything else in your health or life? I was wondering, if it could be your teeth? (You did say wild theories right?!) I had ongoing tooth infection...for years, and my bg would go up when the infection came on. I would then get it sorted, and level return to normal. When I eventuallyhad it root filled, I lost the tooth nerves, couldn't feel the pain of the infection, so I stopped being able to spot the trend. Could you have an infection, arthritus flare up etc etc?

How about an experiment? If you have some, what you think is "good insulin" and some bad insulin, could you switch between the 2 every other day, and see if your BG trend matches the switching? If it does, then I would contact Nordisk, and see what they think. I was wondering whether there is something about the insulin that varies (eg age, slight composition change, that for most people is absolutely fine and is considered normal variation, but for you, causes issues? Like any good experiment, you should try and keep all the other variables the same, so same pen, food, exercise, times of injection etc..and see what happens.

Good luck, and let us know what you find out!

 

[JonnyS31]

Hi Sugar2,
Thank you for the good points!
I know what you mean about Boots stock rotation I was making notes on best before dates of batches and sometimes the "fresh" batch dates would be older then the batches I received the month before - July's best before would be 12/2011 and August's would be 10/2011 - To be honest I don't really understand the best before dates as after 25-30 days the insulins always die on me anyway even with manufacture's storage guide lines and doctors have always prescribed me monthly for what I thought was that reason.
The periods of needing more insulin is more a period of insulin sickness, it takes a few days to creep up and I don't generally take more insulin as this tends to end in headaches as well as the constant high feeling and everything that goes with it.
I've never manage to pin down which insulin causes this effect in a/my way I think they both depend and fail on each other, I realise the background insulin is the levemir and this should keep sugars down at night and between short falls in the Novoripid, I know its the Novo that causes headaches but can't explain the rest of the highs.
The tooth and in fact any infection or injury is a really good point we type 1's need to be aware of. I always look at generally health/well being first when problem solving the diabetes, thankfully I have good teeth and no complications at the moment.
I always try to look at everything before making the assumptions about the insulin; cogged needles, stress, whether, foods/wines with unexpected amounts of sugar, injection site to name just a few trouble is this takes time, I had a cold or some sort of virus last week so i had to wait before making a division about this insulin.
I like the idea of your experiment good thinking I would stretch out the swap over to maybe 4 days and see how it goes.
thanks again I will let you know...

 

[jopar]

From what you are saying it's not duff insulin nor is this being caused by a storage problem at the chemist...

I would be looking at a control factor causing this, either foods you are eating, exercise etc you are or not doing the day before that might be impacting later than you think or has mentioned an brewing infection or such like..

Your insulin that you pick up from the chemist is only likely to been their for ours and less than 24 unless it's a weekend of cause.. Chemists actuall don't keep a large stock of prescription medication as they have it deliverd 2x daily and order what they actually need for prescription with a small over lap..

As for expirey dates the length of time is based on correct storage tempertures, Once you've opened the vial then it goes to 4 weeks and it can be kept at normal room temperture for this length of time.. But needs to be kept out of direct sunlight i.e don't keep it on the window seal with the sun shining in on it!

If you say that your insulin doesn't last for longer than 25 days after you've got it, then you must be storing in the wrong condiditions so I would suggest double check how you store both fridge and where you keeping your insulin while it's in use but out of the fridge.. Perhaps you keep it in a draw/cupboard next to the cooker?

 

[Conrad]

That was a kind of chemist fridge that could be a good storage for the insulin. They need to have this kind of storage so that the insulin takes into a nice temperature. Being stable for the condition of temperature might be very important.