Hi folks. I know we trust our pharmacies very much, and we should! I did, however, run into a scary scenario where I was using a fresh vial of insulin, delivered intact via Mail-order straight to my fridge, and only used it about 4 days before I was in ketoacidosis! I felt horrible, nauseous and tired. Thankfully, no need for hospitalization, but almost! As soon as I used a new vial of a different lot #, I was fine.
Has this happened to anyone? Am I naive for not knowing this could be a possibility sometimes?
I’m sorry to hear that! Certainly nothing is impossible, but the quality control is pretty serious at least to the point that production is complete. It is more likely that that lot or a part of that lot was mishandled post-production, either during shipment to or storage by the Rx warehouse. But keep your eyes on the news, maybe there will be a recall!
Did both lots come in the same shipment? I once got a mail-order supply that spent 8 days in a UPS warehouse without my knowing it until it was too late. Climate-controlled, my #!@. I was lucky that there was enough activity to keep me out of trouble, but nothing is more frustrating than being 200+ and not knowing why!
In 35 years I have never had bad insulin, although I have suspected it a few times. BUT, I always get insulin at the local pharmacy and never by mail order.
Every time Medco mails to me, they use one lot. I get 5 vials per shipment. The “good” lot was leftover from the previous script.
So scary! As I indicated, probably a tiny amount of it was active, and the pharmacist I spoke with thought it got mishandled somewhere, be it heat or shaking somewhere. Scary! Thanks for the input.
Thank you! Interesting. I am pretty sure something happened in transit or the pharmacy storage facility, but we may never know! I’m just glad they are replacing it for me.
I’m also 35 years and never remember getting bad insulin. But I also only get it from a local pharmacist.
I’ve had a couple of bad vials. Was like injecting water. I returned it (CVS) & was given a new one from a different lot number, no questions asked. Once all the lot numbers were the same at my local pharmacy, so they ordered one from another of their stores.
Glad you’re ok!
How do you know it was DKA if you weren’t hospitalized? This is a bit off topic, but just having high BG and ketones doesn’t mean you were in DKA. My understanding of DKA (which I’ve been in 4 times in 18+ years) is that it’s a medical emergency that requires hospitalization. It’s not just high BG and ketones, you are severely dehydrated, your body is exhaling increased levels of carbon dioxide and you’re often hyperventilating, your electrolyte levels are off, and true DKA cannot be corrected with just insulin. I’ve been in DKA and gave myself MASSIVE amounts of insulin, to no avail, because I wasn’t fixing the other things simultaneously.
In any case, I’m so sorry you had a bad batch of insulin! That’s a scary scenario; I’ve fortunately never experienced it, and hope I never will.
It is scary:) We rely so heavily on everyone in the supply chain to do things properly. But, like everywhere else, some people take their job seriously and others not so much!
It happened to me by the same company, but was never even offered a replacement batch. I went to doctor the next morning and they checked all 6 vials of insulin and only 2 were still good according to the lab. I have never ordered insulin again from them and now only go to the local drug store where I can receive a perk for prescriptions and even transfer to another pharmacy once a year and back to the main one for the gift cards offered. Hey, gotta deal with d so why not let them pay me to come to their business once or twice a year.
The problem this time of year is if the mail order insulin is allowed to freeze. I have never frozen any of my insulin so I am not sure Does a precipitate form?
Wow I’ve never heard of that happening before. One time I got high blood sugars because I accidentally used some insulin that had expired, but I didn’t go into DKA. I’m glad you pulled through!
I understand your point, but its actually a lose term which has been confusing. Hospitals use the term to refer to what is happening for Type 1 and Type 2 patients who present with acidosis, but the moment your body is excreting ketone bodies in blood and urine indicates you have entered ketosis, the beginning of ketoacidosis. The Atkins and SouthBeach diets attempted to get people in ketosis all the time, a natural way for the human body to use fat stores during starvation. Diabetic ketoacidosis (DKA) just refers to the “starvation” occurring with diabetes, or a lack of insulin. This happens MUCH more rapidly, and with more serious results. It is scary that you have had to be hospitalized, that must be terrifying. The issue with the body not responding to insulin is also true, in severely advanced DKA, you need those things you mentioned more than anything!
Thanks for saying something, its an interesting point, and perhaps I should have worded it differently.
Yes, during freezing, the proteins (insulin) will essentially “congeal” and cause the solution to get cloudy (if it is not already a cloudy insulin, haha). I have seen a frozen vial before, it does look like grains of sand sometimes.
I have actually had it happen to me a couple of times, once with Humalog and once with Levemir. With the Humalog, my BS skyrocketed as soon as I opened a new box of pens. I had a sample Apidra pen at the time which I had started to use but left it sitting on my desk. The Apidra was cloudy and I had actually meant to toss it but tried it when I had the problem with Humalog. The Apidra brought my BS down so I knew it was a problem with the Humalog. I called Lily about the problem and they replaced the box of pens.
Last summer, I had some Levemir that was not quite as potent as it had been. I had some other health issues going on so didn’t really think it was the insulin until my doctor gave me some sample Levemir pens. I was in the middle of a box of pens when I tried hers and my BS came crashing down because I was using the same dose I had bumped up to with the other pens. As soon as I tried another pen out of my original box, my BS went back up. I called the Levemir people and they also replaced what I had. I told them that I had been having a problem for a couple months but didn’t realize it was the insulin until my doctor gave me the samples. They asked if I knew whether or not the lot numbers were the same on those other boxes but I didn’t know if they were or not. Now when deduct my copay from my checking account balance, I put the lot number so I can keep an eye on them.
A couple times, I had one bad pen in a box. If I think a pen is bad, I will set it aside in the fridge and use another one. If I try it a second time and have the same problem, I know it is the pen. If I don’t have a problem, then I know it was just something going on with me. I have tossed a couple doing that.
I have accidentally frozen (actually, someone at my job did), and it does precipitate. Insulin that has been frozen is ineffective and should NEVER be used. How fragile our drugs are!