Insulin Gone Bad...

[GrantGam]

Hello all

New to the Forum today!

Thought I'd wade in with a problem that has been hindering me for the past 9 months or so...

Diagnosed as T1D in April '14 and after a couple of months had everything relatively under control. Moved house June '15 and a month or so later the insulin stored in the fridge stopped working. Like injecting water, even taking 10 units of novorapid would only keep my BGL the same at best instead of plummeting.

I went up to the chemist and got an emergency prescription, as soon as I took a correction dose things were as they should be. After one month or so again, the same thing happened; insulins lost all potency...

I again went to the chemist, explained my issue and got another emergency prescription (stored in a relatives fridge this time as I presumed our one was shot). New fridge bought, installed and I also put in two temperature gauges next to where I keep the insulin (one digital one analogue) to make sure the value is between the 2degC and 8degC in the door shelf as advised.

The same problem happened another two times since getting the new fridge...

Tried two other chemists in the town but I had the same issue with them both too.

Next time in the chemist I requested enough insulin for me to keep in ambient conditions for 28 days usage and the remainder to be kept in their fridge.

Once my insulin had ran out nearly exactly a month later I took the batch of insulin from the chemist that they had stored for me. And no surprises, this stuff didn't work either...

The only way round this was back to the chemist ask them for a batch of their most recent insulins and only give me enough for 28 days and then I keep going back and asking for the freshest stuff they've had delivered.



As you can understand this is becoming a total headache. I know the following:

-My fridge temperatures are perfect, no freezing because the insulin would stop working the first time it froze which would be after one or two days. And not too high because regardless what time of day I check the readouts they're still between 2degC and 8degC. Also, why did the insulin from the chemist not work?

-Injection sites are fine as DSN had checked them and I'm also injecting the new insulin I get when I'm having these issues in the same areas and it's perfect.

-Stress levels aren't a problem because I can maintain an HbA1c of 5.9% until I start having these problems.

My insulins are:

Novorapid for meals at 1 unit to 10g carbs
Levermir split dose, 18 units in the morning and 18 units 12 hours later

Anyone experiencing/experienced anything quite like this before? I hope someone can point out something I'm doing that's completely wrong but finding that insulin is going bad even stored in a fridge that is monitored regularly is telling me the issue is out of my hands.

Hope to hear from you soon,
Thanks for listening!

Grant

 

[noblehead]

Don't store your insulin in the door, it's the warmest part of the fridge, store it on the bottom shelf.

 

[slip]

temp range for long term storage of insulin is 2-8 deg C, as the OP has said he's put 2 thermometers where he keeps his insulin - and confirmed it's in that range - doesn't matter where its kept in the fridge so long as it's in that range.

I've no idea whats causing the issue but something happens to it somewhere along the supply chain to make it go off, I'd contact novonordisk directly.

If I had to have a stab at what the problem is I'd say if it goes bad after about 28 days at some point it's gone over 30deg C as that's the time novonordisk state to keep it while in use and below 30.

 

[GrantGam]

Thanks for the replies!

Noblehead, as slip has said I keep the thermometers where the insulins are (in the door) so it's not that. Nor is it my fridge because the batch that I asked the chemist to keep was also then rendered useless...

How often do you guys visit the chemist for repeat prescriptions of insulin? Specifically is it less than every 4 or 5 weeks?

Cheers,
Grant

 

[JohnEGreen]

I'm T2 so do not know much about insulin and it's storage but it occurs to me if you keep it in the door of the fridge every time you open the door it's temperature could rise depending how long the door is open then when door is closed temperature will drop again if it's done repeatedly maybe that could have an accumulative effect. So it could matter where in the fridge you keep it inside on the shelf may have a more constant temperature.

 

[slip]

@GrantGam1337 I visit the pharmacist every 4 weeks for tablets, probably every other time I also pick up insulin (novorapid and levemir) and have never suffered what you're experiencing. I too keep my insulin in the door (in the 'egg tray' section which does have a flip up lid). I'm 99% sure it's not the way you store it that's the problem. Just one question - are you sure it didn't 'boil' in a hot car on the way home?

When you had the pharmacist store it for you did you use it pretty much straight away and found it ineffective?

 

[GrantGam]

Thanks slip,

I found I was going back to the chemist every 10/12 weeks for insulin and every month or so for strips and needles. I'm going to just have to ask for half the amount of insulin and keep going back once a month

I'm also storing in the egg part of the door, with it's only little slip cover.

No it was definitely not in a hot car where I'm from haha and also just a 2 minute drive from the chemist.

Yes, when I realised that my insulin (both in use and stored in the fridge at home) has become useless I went straight up the street to get the stuff they had kept aside for me. As soon as I got it home I took a large correction dose and tested after 1, 2 and 3 hours with no drop in BGL.

 

[slip]

And your chemist is aware of the issue? One or both of you should report this to novonordisk. May be ask the chemist if anyone else is having the same issue.

Just realised you're in Scotland so take back the hot car query!

 

[GrantGam]

Yeah I've mentioned this to both chemists that I used. I also asked the chemists to contact Novonordisk and inquire about the issue. Last appointment with the diabetic specialist she had a look at their records and found no reports/info of bad batches requiring recall.

I'm completely stumped as I've done all I can, new fridge, different chemist, different storage. I'm also a creature of habit meaning that there were no out of ordinary circumstances leading up to this like change in exercise routine, diet, etc.

Not to worry, will get something sorted

 

[noblehead]

Thanks for the replies!

Noblehead, as slip has said I keep the thermometers where the insulins are (in the door) so it's not that. Nor is it my fridge because the batch that I asked the chemist to keep was also then rendered useless...

How often do you guys visit the chemist for repeat prescriptions of insulin? Specifically is it less than every 4 or 5 weeks?

Hi Grant,

The reason why I mentioned the fridge door is because you have greater fluctuations in temperature there, if you leave the fridge door shut for a while the thermometer will say the insulin is stored at the right temp, but if your cooking and in and out the fridge all the time then you'll be surprised how the temp can rise, but would that make a difference I couldn't honestly say but if you do a google search you will see that the warmest part of a fridge is the door (hence why I mentioned it).

As you've had insulin from two different pharmacy's and have the same issue it may be that the Wholesaler where they purchase the insulin from isn't storing the insulin at the right temp, maybe worth chasing this up and ask your DSN/Dr if any other insulin dependant patients have had similar issues.

I just order my repeats as and when, no set pattern but usually it's around 6 weekly.

 

[slip]

if your door egg tray is between 2-8 then the rest of the fridge is really cold! Just right for storing the champagne!

 

[GrantGam]

I've moved my insulin to the back of the fridge on a main shelf.

Hoping to get this sorted out because that was another emergency prescription needed and due to the nature of my job (working away) it wasn't convenient in any way!

Still convinced this is an issue outwith my control but I'll be sure to keep you posted!

Thanks,
Grant

 

[Gemma2]

Had a terrible day yesterday. B/sugars in the high 29's,s all day. Not food related! However much insulin I pumped into myself made no difference. Did 2 cannula and insulin changes with no effect. In the end I discovered I must have had a DUFF LOT OF INSULIN!!!!! AFTER A THIRD CHANGE AND NEW BOX OF INSULIN BACK TO NORMAL TODAY. Thank God. It was scary as I live on my own.

 

[asparagusp]

A scare indeed! I would have freaked out! Glad to hear you came through it successfully!

 

[Gemma2]

I did freak out as it was New Years Eve and the 24hour emergency Clinic number I had wasn't being answered!

 

[azure]

I did freak out as it was New Years Eve and the 24hour emergency Clinic number I had wasn't being answered!

Glad you're ok @Gemma2