I have been reading posts here lately, telling others to use an alcohol swab on the bottle of insulin before using. I haven’t done this in years. I think I read at one time that this is not necessary, and stopped doing it. Any ideas on this subject?
I don’t bother with it. Nobody touches any of it but me. Although it is in the fridge, it’s in the butter dish holder by itself.
That’s another thing, I use Apidra and don’t refrigerate it once I start using it, but I’ve been reading posts that people keep theirs in the refrigerator even after starting a bottle. What gives?
To me, I want to make sure that it works as well as possible. Plus, I’m not sure where else to keep it? I hardly ever have a bottle that doesn’t work although I just had a very frustrating couple of weeks where that very thing may have happened. I finally used a new bottlle this AM and blammo business as usual! I dunno if the refridgeration helps or not. It’s sort of hard to say. Like I had some sensors that were wierd and called Medtronics to kvetch about it and beg them for new ones and the guy was like “oh, I’m sure that wasn’t it, we test them to 140 degrees…” so why does it say 85 degrees or whatever then? That drives me nuts, “we need to be safe because our lawyers have no cojones so we are going to not tell you what we know…”
My thought is YES to both. Why add additional variables? Bacteria are hearty things and can grow pretty much anywhere. It doesn’t take long to swab it and then I know it’s sterile before I inject it. Also keeping it in the fridge removes the temperature fluctuation variable. Does it make a difference? Pry not, but with a lot of things I use in the lab they say they are good at room temp but always last longer and work more efficiently over the long term when stored in the fridge.
What SuFu said…lol. I don’t know that it needs to be refrigerated, but it’s convenient, and yep, less variables. I’m a bit more cautious with my infusion set practices than I was with my pen use…it is, after all, an open wound! I never used alcohol swabs for injections. The other day at the doctors I tested and she offered me an alcohol swab! I laughed. My fingertips are callused and dry enough from testing 10 times a day - alcohol is all I would need!
Agreed. With the huge exception of when I’m in clinic or hospital. Then I wash and alcohol before testing. Hyperparanoid about MRSA! lol!!!
I can’t remember the last time I used a swab on the insulin bottle. Maybe it was 20 years ago… I use Novolog and keep my current bottle at room temperature. I use each bottle until it’s empty and my guess is that is about 5-6 weeks. I fill my pump reservoir and use it until it gets down to about 10 units. That’s usually about a week or a bit more. I don’t ever have issues that I think are related to insulin degradation. My issues tend to be related to things like chocolate frosted old-fashioned donuts…
I do use IV Prep with pump infusion sets. I use plain alcohol swabs when inserting my Dex sensors.
I hardly ever change lancets and I never use alcohol swabs when testing BG. I rarely wash my hands before testing, although I have been known to put the intended victim finger under running water and then dry it.
When I think of how many injections, BG tests,etc. I’ve had in the last 35 years, it’s an amazing amount of time I’ve spent on those things. But at least it’s less time than it would have been with daily lancet changes, alcohol swabbing for each injection and test, etc.
Well, I am not currently using vials, I’m using pens, but I think my answer is relevant to both. In both cases, you are sticking a needle through a rubber stopper. And the best I can tell, the situation is exactly the same as far as sterility is concerned. The only difference would seem to be that a vial is kept out in the open in the fridge with the stopper exposed and the pen has a cap. If you look at the guidance (and I’ll use Lantus as an example), you are told to use an alcohol swab on a Lantus vial before use. But you a NOT told to use a swab on a Lantus pen.
So my conclusion is that the swabbing is only needed because of the increased exposure of the vial stopper. I don’t think this is a huge risk, so I never bothered with it. But then again, I also inject through my clothes and a few other bad practices.
Why do you use IV Prep on pump sets but not the Dex sensors? I also use alcohol swabs on my Dex sensors, but nothing when inserting my pods. Makes me wonder why I don’t?
Yes, I use an alcohol swab each time I remove insulin from the vial. I blame this on flashbacks to undergraduate microbiology.
I can see the concern however my batting average in 23-4 years of shots and now about 3-4 years of pumping is zero infections. I’ve had a couple of blow outs and blood gushing all over the place but nothing that stuck. Still, the consequences are grisly? Sometimes I wonder if hypos are good for killing germs too?
I haven’t used alcohol swabs in probably 20 years.
Never have even directly after Dx. I read a study where they had actually TRIED to get bacteria into a vial of insulin and despite swabbing bacteria all over the top and repeatedly putting a needles through the stopper after swabbing it with the bacteria they could never get anything to grow after being sterile about opening the vial to see. They of course concluded you SHOULD swab but the risk was quite low if you do not. Wish I had kept that reference but I read through so much research I not sure where I read that one. It impressed the conclusion that I have which is diabetes is SO much work why add one more variable. I do not use anything for my infusion sets either but I tend to consistently do that after a shower. Can’t say I have had a single infection (from any source) since I had zits (after all that is what they are right?) in my coming to age. Boy did those antibiotics make me sick! Decided I would rather have zits…
Oh and SuFu re: MRSA. Anyone that has spent any decent amount of time in a hospital is already more than likely colonized with MRSA. It is interesting because when they nasal swab for MRSA, should an employee of the hospital end up there, they are almost always positive. I hear the intensive care Doc’s grumble all the time that nasal swabbing for MRSA for infection control is a waste of time as all the employees walking into each room has a pretty good chance of already being colonized anyway. Guess the good part is you get your own room that way 
Bad part is it is hard to control the spread of MRSA because of it. Guess that’s why washing hands when going in to a room is harped on so much.
I’m betting they would kill us before the germs.
I will do the alcohol swab thing, ONLY IF the top is obviously dirty or has been exposed to dirt/grime. If it’s clean and has been kept in a nice clean place… I have no problem.
Now, 25 or 30 years ago, yes I did do the alcohol thing every time on the bottle and the injection site. But now it’s down to the couple times a year when something’s obviously dirty.
I used alcohol for years, but I remember reading somewhere that it wasn’t necessary, maybe it was Diabetes Forecast or Diabetes Self-Management magazine? That was before the Internet and the only diabetes information I got was from these magazines. I no longer subscribe to them because I get more information from this website.
Agreed. We all have it, but skin is a great barrier. I’d rather not take the chance of getting a blood infection with MRSA. Seen it and it’s not good. Having had to watch a surgery where they had to strip out the infected veins from a guys arm and remove a good deal of muscle is reason enough to double clean before testing.
Never. In fact I use the pump and I never use alcohol or wash my skin before injecting the pod. Before that, when doing needle or pen injections, I would sometimes inject through my clothing. In 23 years of using insulin, I have never had an infected site.
I think it goes back to my original training for the Minimed CGMS where I was told not to put anything on the site that could compromise the sensor. I think I read or was told not to use IV Prep with the sensors.
I’m tempted to try IV Prep with my Dex sensors because they really don’t stick very well. I usually get almost a week before all of the edges are peeling up, but they are close to coming loose from the start. After a week I add tape and get sufficient adhesion for another week.