Insulin Freshness

[StewM]

I've seen a lot of people on the Forum talk about getting rid of spoiled or bad Insulin. One thing I've always wondered is what criteria do you use to determine if this is the case? Like I know lack of potency is one thing that a lot of people point to, but with Insulin requirements fluctuating for other reasons, how do you decide whether it's the Insulin or your body?

 

[EllieM]

but with Insulin requirements fluctuating for other reasons, how do you decide whether it's the Insulin or your body?

It's a good question. When my bg goes up without reason gone off insulin is one of the possibilities I consider. So I change the cartridge and if the situation improves I reckon that the insulin was bad.

(Another significant possibility is a poor injection site, so I also monitor that carefully.)

 

[Deleted member 527103]

I rarely chuck unfinished insulin unless it is out of date.
But I do consider it as a cause if my blood sugars are rising without any obvious reason such as illness, lack of exercise, stress or pump issues.
It is the last thing I dispose of when I have discounted all other reasons.

 

[ert]

My blood sugars rise and I feel like I'm injecting water. That's when it's the insulin not working.

 

[NicoleC1971]

Weirdly a couple of people in my t1 group pointed out they'd put fresh vial and noticed they were in perpetual hypos so that might also be a clue that your previous supplies were not at their best.

 

[Jaylee]

Hmmm, inadvertently "cooking" it in a hot vehicle or leaving it lying about in the conservatory during summer?
I'm pretty insulin sensitive. So with regards to the basal I use, (Lantus.) I've learned that if it is way off with under-performing? Changing the cartridge will remedy the issue with the next for the following day..
I find the Novorapid actually more robust than the basal?

 

[becca59]

It is usually the basal (Tresiba) for me that is the issue as it is the vial that lasts me the longest. It would be great if you could get half sizes as at 6 units a day it doesn’t go down fast. It states 6 weeks on the instruction leaflet but I usually dispose of after 4. I always notice a decline of good control during the fourth week. I mark on the calendar when I start each new vial to keep an eye on things.

 

[StewM]

My blood sugars rise and I feel like I'm injecting water. That's when it's the insulin not working.

What would you say 'injecting water' looks like to you? Like I obviously get a sense of what you mean, but it's one of these things that can be easily said without a clear sense of what is precisely is meant by it.

 

[ert]

What would you say 'injecting water' looks like to you? Like I obviously get a sense of what you mean, but it's one of these things that can be easily said without a clear sense of what is precisely is meant by it.

I'm super insulin sensitive. If my insulin is off, I can inject short-acting my usual calculations without any blood sugar changes over 5 hours. If I change my insulin vial it works again straight away.

 

[Circuspony]

I binned an entire packet of Tresiba at the beginning of the year. Morning BG were ridiculously high (lockdown so hadn't been anywhere). Changed cartridge and no different with BGs rising through the day and having to adjust with Novorapid. Tried a cartridge from a newer box and normal within 48 hours.

When that cartridge was finished I used one from the previous box but up went my BG again so I threw it all out. I'd had it in the fridge but perhaps something had gone wrong at pharmacy or in transit.

 

[Hopeful34]

I'm on my second vial with the same batch code, and it's super strong. Alert after alert of impending low, and one or two actual hypo's as bloods have dropped so quickly. As an experiment, I opened a different batch number and bloods were back to usual.

I've had this before, and previously posted somewhere about an investigation in America where they tested lots of different batches of the same insulin, and some were only 30% strength, whilst others were I think from memory 70 or 75% strength. They were calling for the same investigation in the uk, but as far as I'm aware it never happened.

 

[StewM]

I'm on my second vial with the same batch code, and it's super strong. Alert after alert of impending low, and one or two actual hypo's as bloods have dropped so quickly. As an experiment, I opened a different batch number and bloods were back to usual.

I've had this before, and previously posted somewhere about an investigation in America where they tested lots of different batches of the same insulin, and some were only 30% strength, whilst others were I think from memory 70 or 75% strength. They were calling for the same investigation in the uk, but as far as I'm aware it never happened.

I do find this interesting as my Tresiba in particular seems to vary massively in strength (dose to dose).

 

[LionChild]

I've seen a lot of people on the Forum talk about getting rid of spoiled or bad Insulin. One thing I've always wondered is what criteria do you use to determine if this is the case? Like I know lack of potency is one thing that a lot of people point to, but with Insulin requirements fluctuating for other reasons, how do you decide whether it's the Insulin or your body?

I think Levemir and Novorapid should not be used (once out of the fridge) for more than 1 month.

 

[TypeZero.]

I've seen a lot of people on the Forum talk about getting rid of spoiled or bad Insulin. One thing I've always wondered is what criteria do you use to determine if this is the case? Like I know lack of potency is one thing that a lot of people point to, but with Insulin requirements fluctuating for other reasons, how do you decide whether it's the Insulin or your body?

Visual inspection is the most common way I identify denatured insulin.

There have been times where I have forgotten my insulin under the sun or near a radiator.

The appearance of insulin becomes:
-Cloudy
-With precipitation, small visible particulates
-Brown tinge to it

Depending on how bad it looks I might continue using the insulin, I find that sometimes with Fiasp you can see some floating particulates in the insulin but it’s efficacy is the same