Spare/Back up Insulin Pens

[Debloubed]

Does everyone with a pump still get pens prescribed easily? I had to use my pen the other day as had a huge BG spike due to a blocked cannular (first time it had happened) so I needed to use my pen for the correction bolus whilst I worked out what was causing the high BG (I had corrected with the pump but no change after 1 hour). As the pens only last for a month out of the fridge, does anyone struggle with getting regular repeat 'scripts for pens which are going to be binned after a month? My DN tells me I should get a box of 5 pens to last me 5 months, even if they are going to be thrown away, one by one, after the month is up.

 

[jopar]

Yoy need to have both quick and back ground insulin available for emgerncies...

I know some choose to return to a syring for their quick acting, so they can draw from their vials of insulin..

And you should have a plan of action for restarting background insulin if it's necessary to do so if pump goes out of action..

I'm lucky as having a T1 husband who uses the same background insulin as I used to use, I have permission that if I ever need background in emergency then I can swipe of cartridge of his to use.

So all I need to keep is some spare humalog...

 

[Debloubed]

thanks Jopar, understood, but do you have probs getting your 'spare' insulin prescribed? My pens have been taken off my prescription, GP seems a bit clueless and I had a fight on my hands to get my new Combo strips prescribed! all sorted now (following a letter of complaint to the practise manager) but I can now see the pens have been removed.........*sigh*!! Just wondering if anyone else has had that problem?

 

[iHs]

I carry a spare pen in my bag just in case something goes wrong.

My GP has also now removed my bolus cartridges from my repeat but left the background :roll: :lol: but as I still have a couple of part used cartridges, I just fill them with a syringe from the vial so that there is about 15 units in them and then load them into the pen. Bit like filling a reservoir but using glass instead of plastic cartridge. :wink:

 

[Debloubed]

I have disposable pens!! :lol: So would need syringes to draw from my pump vials........imagine trying to get those back on my 'script after so many years of pens, Nightmare!! :roll:

 

[Alzibiff]

After a year of being on my pump, I decided that I should get "sorted" just in case so asked for a couple of disposable insulin syringes, the idea being to have something without a shelf life and just there in case of emergencies. Well .....doctor lady was totally confused and wrote me out a script for a pack of standard syringes until I pointed out that specially marked INSULIN syringes should be available .... which she found on her computer eventually. So... I have five 0.5ml insulin syringes in my drawer now - just in case - and if ever needed will draw up the quick acting stuff from my vial.

As for background insulin, I have not bothered getting any of that either in a pen or in a vial. My "disaster recovery" plan would be to stick with multiple quick acting injections pending delivery of a replacement pump should that be required - I would hope that my supplier could get a replacement to me within 24 hours. Saying that, if I made plans to go abroad - a vial of long acting insulin would need to be considered!

Alan

 

[jopar]

My cartridges aren't on repeat any more, I phone my sugery DSN if I need some... When they were they would get mixed up, I ask for vials and end up with cartridges etc...

Alzibiff

I'm afriad there is a shelf life to insulin syringes, I've just dumped my last 10! due to being past their expirey date it's on the pack...

I don't have needles for my pen either, but again if necessary I can swipe some of hubbies..

I have spare pens for both insulins in the cupboard..

As to carrying spares, if I'm near to home then I tend not to bother, but if like sunday I had a 2 hour drive to a dog show, I had full spares including battery for my pump...

Almost all motorway driving :evil:

Big day both for my dogs, both are rescues, Jones I have been working with for a year as he was scared to death of the world outside a kennel environment basically agoraphobic :cry: Took the whole lot travelling, the show all in his stride and even came first in his class the icing on the cake :mrgreen:

And Ellie my German Shepherd pup, still needs a tad more work :lol: Deciding to play bow and play with the dog next to us, doesn't impress the Judges But hey she came first in her rally last week so she's forgiven, won't be long now and we can start low impact algility with her..

 

[phoenix]

You really need some sort of backup system.
They insist here that you have a 'schema de remplacement', five rapid and 5 long acting pens. The pump supplier/nurse comes to my house every 6 months and as part of her visit always checks that that the pens are still in date!

I hate the waste involved so I've found two ways of minimising it. Firstly, as suggested by my pharmacist, I give him advance notice so he can get in new pens with the maximum expiry period.
Secondly, when they've got a couple of months to go before expiry I use the Apidra pens to fill up my reservoir. Still have to throw away 5 levimir pens though.
At the moment I've couple of pens that have been backwards and forwards to the UK, have been on long walks in some very hot temps albeit carried in a frio, so they've been in and out of the fridge, and definitely above 8C. I wonder a how good they will be!

 

[JANROU]

I only have the insulin syringes as backup and draw from the vial i'm using, the syringes are on repeat prescription so no problems when their sell by date comes round. I'm quite happy to use the syringes as carrying a couple of those takes up less room than a pen. However i've not got any long acting insulin as a backup, do i really need this or could i just sort it out if necessary?

 

[jopar]

Yes you do really need the background insulin

If you pump breaks down completely you'll looking at least a 24/48 replacement and weekends/bank holidays a little longer..

If you've no background to fall back on, then you have to use your quick to cover your basal insulin, and you then have to inject this every 2 hours! One thing doing this for prehaps up to 10 hours during the day but really not practical to do over a 24 hour period or longer!

It's a shame that we wasting insulin like this But look at it this way..

If your pump goes belly up, and you've got no other method or insulin to inject MDI fashion, it won't be long before you start to hit DKA etc, if you lucky you create a rather expensive hospital bill or if you unlucky you won't need your pump repairing!

 

[iHs]

Hi

Although I agree everyone should keep a supply of background insulin in their fridge and have a rescue plan of using a disposable syringe/insulin pen stored in their bag when out and about in case pump plays up, I don't agree that insulin past its use by date should be discarded.

Insulin that is stored in fridges will keep way beyond its use by date. It may possibly not be quite as effective but never the less will still be ok. I once used Humalog that had been stored in my fridge and had a use by date of 2006. I used some of it in 2008 and it was still ok. My bg levels were ok and I just used my usual amounts (same as Apidra which I had run out of).

Even insulin that is taken out of the fridge and used at room temperature will still be ok for many weeks. I only used small amounts of Lantus so if following the manufacturers info sheet, 30% of Lantus in pen would have been thrown away as it would be thought that it would not be effective. I never did this and only discarded the insulin when the cartridge was empty.

 

[Debloubed]

Hi IHS,

This really interests me! As contoversial as your words are I've often wondered how out of date insulin would react? Obviously, for the sake of this forum, it's not to be recommended, but really, if it's a month or 2 over, I've always assumed it would be ok?! I think I would be wary of using non refrigerated insulin after a month but in an emergency, I would use it. I hate the waste as much as everyone else! I actually struggle to throw the full pens in the bin :lol: But as Jopar said, the cost is relative to the cost of being in hospital with DKA......these things are sent to try us :mrgreen:

 

[sugar2]

Well, I agree with Ihl, I have used out of date insulin with no ill effect..and we are talking about an "emergency" not regular use.

I know that sometimes it is teh degradation products that can be problematic, as well as teh efficeincy of the insulin that needs to be taken into account...but in an emergency, when you shouuld be testing all teh time anyway, |I don't think we need to get too hung up about the use by date. I would not say this if we were using this insulin all the time, but for occasional use, I have found it to be OK.

Same thing with the syringes...they do not degrade, and if they have been in your cupboard for years, they are unlkiely to be contaminated. I believe that the use by date is based on the sterilition process, and they can only guaranttee the sterility.

I admit, I am old school...and remember teh days where things were not so clean etc. They were also days, where, in general, diabetes control was not as good, so I am in no way advocating we go back to them...but in an emergency, we need to rekaz a little. Don't want to be using ancient insulin...but if that is what you have to hand, it is better than nothing