It seems like my insulin is less effective on day 3 and especially ineffective at the end of a vial. It seems like I go hyperglycemic at the end of the pod life and especially at the end of a vial. Based on information from my CDE, I don't refrigerate my Humalog vials after I start using them.
Have anyone of you noticed this?
Has anyone found a way to test the remaining insulin in a pod for potency, or found a way to have it tested?
Do you refrigerate your insulin after you start using a vial?
How many days do you keep a vial that you have started using before you toss it?
I hate to waste insulin, but if it isn't working, I'm not really wasting it if I toss it. Hmm.
Any ideas or comments would be greatly appreciated..
I haven’t found that to happen to me…I use Novalog . I don’t use the vials, I use the pens to fill my pods. I keep it refrigerated. The only thing I don’t refrigerate after starting a new pen, is Symlin. I keep the unstarted (is that a word?) pens in the fridge.
Brad, my doctor has told me that a bottle of insulin once you start using it only last 30 days and then it will start to lose its potency. I don’t keep the bottle that I’m using in the refrigerator but I have the insulin used up before the 30 days. Are you still hyperglycemic after changing the pod? Sometime a site will go bad on me on day 3, its usually my back, and my BGs will start to run high until I change the pod.
Usually after I change my pod I slowly return to better numbers. (I was going to say normal, but I don’t think I am ever normal. lol). It might be an absorption thing, sometimes the spot where the cannula was is slightly red and hard. I guess I have to start keeping better records so I can go over it with my endo or CDE.
A vial lasts me about 21 days. I use 150 units in a pod, so the seventh pod has a mix of the vial I am finishing up and a fresh bottle. I have considered tossing the old vial and always starting fresh; it’s just I hate to waste insulin.
I keep my unstarted (it’s a word in my book!) vials in the fridge. Once I start a vial I keep it out. How long does it take for the pens to come to room temperature so you can fill the pod? I’m really bad when it comes to planning a changeover (is that a word?). It’s usually grab a fresh pod, fill it and slap it on.
I use Apidra, but I’ve used Humalog and Novalog at one time or another in the past. I keep my vials in the frig all the time (regardless of brand name). I only take one out to do a pod change.
If I plan to change in the morning, I’ll try to remember to set the bottle out before bed (so it’s room temp when I go to fill the pod). If I forget, or miss the chance to pull the bottle out, I will draw up the insulin and then ‘roll’ it in my hand for a minute or two (the way I used to do w/ cold insulin in a regular syringe so that it wouldn’t hurt as much) before I put it in the pod (to prevent any ‘errors’ from alarming during the priming/start up of the new pod). After I’m done changing the pod, the vial goes back in the frig.
I think as long as you don’t ‘confuse’ your bottles in the frig, and just use the most recently opened one, there shouldn’t be an issue. I prevent this confusion by keeping all my other vials in the boxes, and then the open one remains out of the box. Pretty much fool proof
Alto of issures there! Yes, I have had these issues as well…in fact, just last week I had to call Lilly and ask about a vial I had just purchased last month from a local Walgreens, and they took the serial numbers and replaced the bottle without an issue. Theuy told me this has been happening on an elevated level lately, so they did not present any kind of arguent. I refirigerate all my insulin after the first use, but take the bottle out of the frige 12 hours before I change my pod (because the pod will “scream” if the insulin is not at room temperature) and have not had any problems there. Sometimes, but not all the time, the pod DOES seeem to lose it’s potency around the end of the second day, but, as I said, not always. And, not enought for me to need to do something about it. I sometines have to go back to shot therapy on the third day to be sure my bg’s stay within range. And I use Novalog. Peace, man!
I never refrigerate my open vials - I haven’t for the twenty years I’ve been diabetic, and a bottle of fast-acting used to last me a month and I’d be carrying everywhere I went on MDI. On a pump, the bottles last me about 2 weeks and I can’t imagine refrigerating it. I do keep the unopened ones in the refrigerator door though.
I’ve only had a few vials in my life that looked cloudy and threw them out when I questioned their effectiveness. And I’ve had it happen with R, with Humalog, and with Apidra. But like I said, all of those actually changed from clear to not so clear.
I would wager that it’s more than likely an absorption issue. You might be one of the lucky folks who needs to change a set/pod out every 2 days. It’s worth asking for a prescription for 2 day pod changes for a few months and seeing if that changes anything.
Humalog is not as stable as Novolog is (per my doc) and he says that it’s much easier to kill off. I however am not as sensitive to Novolog as I am to Humalog
Could your site be getting infected or your skin closing off the pump site thereby limiting your insulin delivery? I’ve noticed that it happens to me if i let it go for 5-6 days without changing my pump.
