I am a type 1 diagnosed just over a year ago. I eat a Low Carb diet. My Bolus insulin need are very small. Some days I take 0, other days it could be .5 -1 units 1 or twice a day. My insurance does not cover pens and I find if tricky to get .5 units in a syringe.
So my question is. Does anyone dilute you insulin? I think it would make it easy to use, and the vial may last longer since I would only need to pull 30 units out of it once a month, limiting the amount of possible contamination and exposure. I know you should only use it for a month, but it seems you could maybe extent that date.
Insulin dilution is most commonly used in children who have small TDD needs. Humalog and Novolog may be diluted with sterile diluent that can be special ordered from the manufacturer. You will also need sterile vials to do dilution. There are instructions to do this or you could ask your pharmacist to prepare it for you.
But please understand, Humalog and Novolog vials should be stored for 28 days either at room temperature according to the prescribing information.
TuD member, @2hobbit1, posted this info about the diluting insulin. She used diluted U50 insulin that she mixed herself.
Making U50 is simple - one vial of U100, one vial of diluent, two 5cc syringes, use the 2 syringes to take 5cc from each vial, then swap syringes and return to vials. It makes 2 vials of U50, they will keep in fridge for about a month and a half before starting to deteriorate.
Hi all,
Yes I pump U50 Novolog. NovoNordisk is still making diluting fluid for its novolog. Not sure if the diluting solution for Humolog is still available.
The diluting media is the identical solution/preservatives etc that the standard U100 is made in. It is only available to your Endo, from NovoNordisk. You endo must fill out the paperwork to get it shipped to their office. It has a similar shelf life and storage conditions as the novolog does.
Making the dilution is fairly simple, once you get your endo onboard. It simple requires a script for the 5cc syringes and needles required to do the exchange/dilution. Once made it has the same stability any other open but refrigerated vial of insulin.
It takes some thought and initial math to change from U100 to U50.
For every 1 unit of U100 you will need 2 units of U50. Also if your U100 I:C ratio was 1 unit per 10 gm of carbs, then for U50 you will need 1 unit per 5 gm of carbs. Correction factors are also half of your U100 crew so if using U100 your CF is 1 unit drops your BG 100 mg, then 1 unit of U50 will drop you 50mg. Your duration of insulin activity is still the same.
You will need to work with your endo on the math involved with marking the switch, and how to do the dilutions. Once it’s set, then there is no additional mental math other than accurate carb counting.
Doing basal and bolus testing will still be the same.
This would require syringes for MDI, since U50 is not available in pens. Depending on the type of syringe your doc writes for you can get unit markings that allow quarter unit approximation. If you add that to U50, you should be able to micro dose.
So, other people with diabetes and children with diabetes have diluted insulin before. It requires the cooperation of your doctor and getting the correct diluent from the insulin maker.
What type of bolus insulin do you use? You can dilute Humalog with Diluent, but you need to get that either premixed at a compounding pharmacy, or your doctor has to somehow procure the Diluent. It’s not something you can get as a prescription. There might be another way to dilute insulin with Novolog or Apidra, but I’m not sure about that.
We used to dilute insulin with our son but we graduated out of that about 5 months ago.
EDIT:
Sorry, I misread that, you don’t have pens.
You can get the BD half unit syringes, but if you were to dilute you would have better accuracy.
The most accurate way to dilute is to buy some sterile vials. Don’t rely on the volume that it says is IN the insulin vial, that is not exact. I believe when they say insulin has 10ml, they mean you can get at least 10ml out of it. It was never exactly 10 ml.
So if you want to dilute, here a couple of recommendations. Buy some sterile empty vials. When you dilute, write each amount down as you are doing it, so you don’t forget (“did I put 200 units in there or is it 300 units???”) So for example, if you put 200 units of humalog, and 200 units of diluent into the sterile empty vial, you get to 50%. Don’t try to dilute directly into the insulin vial, because you won’t be accurate! Use the empty vials. I can let you know where I got mine, they were very cheap.
Get the sterile diluent from Lilly, or whoever your insulin brand is. Lilly requires that it be sent to either a doctors office or a pharmacist, but I did not need a prescription. They sent me a case for FREE.
And finally, mark the value on the vial of diluted insulin so you will know how much and when it was diluted!
Yes I have. But since I only take .5 units - 1 unit at a time I was concerned with the percent off I could be at low doses. .2 units off if you taking several units may not be much , but it would be easy for me to be 10-20 percent off my desired dose, or more.
