Insulin Contamination

Last post dated May 2014 about a member that said that his insulin was pink and asked if anyone knew what that meant. After nearly 30 years of taking 6-8 shots of Humalog insulin each day (MDI), I have that same incident just happened to me yesterday for the first time. I use 300 ml cartridges of Humalog and there was about 75 units left in the cartridge so decided to see how my blood sugar would be affected using this tainted insulin – See Photo Below. I use BD Ultra fine 31 gauge 5mm (3/16”) and use a new needle about every 150 shots or so.

I am fully aware of all the CYA information by the manufacturers to use needle once and discard, don’t use insulin past xx days, don’t use inulin if other than colorless, wipe the rubber seal, etc.

My question is there anyone with experience testing BG’s after using insulin that has been contaminated with what is probably blood in either a pen, cartridge, cannula or tubing?

My BG’s ran normal throughout the night using the contaminated insulin and are running about 10-12 points higher than normal during the morning and normal during afternon. Will see how the day progresses and if BG’s get worse, will toss my remaining 60.4 units. Just looking for input from others that may have had a similar experience. Also just changed G5 sensor 2 days ago and hit a vein causing significant blood under sensor which is a very rare event but makes it tough to determine with certainty if any BG anomalies are due to blood in sensor or tainted insulin. CGM matching fingersticks so far within 10 points.

On VERY rare occasions I’ll see blood migrate a few inches up my infusion site tubing. Not the same dynamic as MDI, but it was blood diffusing upstream from the injection site. I change the infusion set but not the pump reservoir.

If I had a bottle of insulin that was colored red, blue, green, yellow, gray, brown, purple…you get the idea…I wouldn’t use it!

No experience with tainted insulin. However. It seems to me, blood has migrated back into your cartridge,. Perhaps you pulled the plunger back while you pulled out your needle.

I use a digital pen so plunger only goes in 1 direction until cartridge is empty. I am really not concerned about what caused it as this is the first episode in past 65,000+ shots with these digital pens over past decades. Just looking for individuals that have had the same experience and have insight how it affected or did not affect their BG’s

OK, I’ll bite: HOW did a vial get contaminated? I’ve used many bottles of insulin between 1978 and 1996 with needles. 1996 is when I switched to a pump.

I reuse my insulin needles. The other day I drew up some insulin and noticed a tinge of red and then the red got redder!

I decided to not inject it, but I had almost pushed the plunger to put the red-tinged insulin back into the vial. I stopped quick enough and pulled a new syringe out of my bag and drew up insulin out of the vial, which didn’t show any tinge of red.

I deduced I had probably had a droplet of blood on the tip that was drawn up into the syringe when I pulled back the plunger. I’m still using the same vial and I’ve not noticed any change in its color or effectiveness, so any blood on/in the first syringe did not contaminate the vial thank goodness!

I am now 24 hours into using the contaminated insulin and need to increase I:C dose by 16%-17% in order to maintain my BGs where they were with non-contaminated insulin. Will be interesting to see if tomorrow will require the same or get worse. There is only 40.2 units left in the cartridge to use up, so less than a 2 day supply and then will know if this ever happens again if I just adjust for the contamination or throw it out.

why do u use needles instead of pens, may I ask?

Sure you can!

I use the vials to fill the OmniPod. When I made the change to just use the OmniPods for basal and to inject for bolus/corrections, via syringe and vial, I never asked for pens.

I’ve read where I can draw the insulin out of a pen and use it to fill the pod, but I have a nice supply of syringes (in two lengths) and vials of insulin. It works for me right now. :slight_smile:

Thats odd. I would toss it. I’m worried about infection.

I use needles (syringes) because they don’t sell FiASP pens in Canada.
Does anyone know if they’re available in the US or Europe / Asia?

My test is now over as I have used all the contaminated insulin in the cartridge. Final results of this test shows that for me, insulin contaminated with blood still works, although not as well as non-contaminated insulin. As i was drawing down the remaining 75 units of my contaminated insulin from a 300 ml cartridge, it became less and less effective, By the time I was at the last 20 or so units, had to increase I:C by almost 50%. Will I ever use contaminated insulin again? Yes, as I don’t believe that 1 test is enough for a definitive proof of % degradation. If this happens again, I will test again and then make a final decision for the future. Always interested in results from others that may run a similar test.

Ah, the beauty of a CGM to be able to do these tests!!!

You are creeping me out. LOL!

Hey, we inject insulin into our blood from time to time, not willingly, and it does not faze us beyond maybe an ouch. So begs the question what happens the other way around. We certainly talk about the effect of bloody sensor insertions which don’t affect me yet others claim to get screwy results when blood builds up under their sensor or transmitter. When you travel a good part of the year, Insulin for 1 odd reason or another sometimes becomes scarce and every last drop counts. Now I know that I can count on blood contaminated insulin in a pinch, if I need to. For me was a worthwhile teaching moment.

Actually I think what really motivated me to do this test was a couple of months ago I got a new housekeeper and she wanted to deep clean refrigerator and freezer. I took all my insulin out of the refrigerator and put it in an igloo cooler and specifically told her not to touch the cooler. After deep clean, she decided to do me a favor and she put all my insulin in the freezer. Fortunately, I came home for lunch that day and found out she had just put it in freezer 10-15 minutes earlier. It did not freeze so all was OK, however, was a close call certainly would have been an expensive, time consuming mess if I would have had to replace all my insulin.

The idea of using insulin that is contaminated to the point that it is visibly red, turns my stomach. It can’t be a good thing to have blood at room temperature for days or weeks, along with the insulin that you will inject. Yuck. I’m obviously more of a clean freak than you. :slight_smile:

Freaks me out a bit as well. Irrational fear no doubt. I certainly understand @CJ114 why you ran the test. Makes sense.

For a brief moment the thought of a bloody insulin-vial Halloween costume crossed my mind…

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I have used syringes and vials for close to 40 years, very very frequently re-using syringes.

For a while in the 1990’s I re-used syringes so much that sometimes the unit markings were barely legible :slight_smile:

Yes I remember seeing some tinges of blood in the vial when the flow went the wrong way for just a little bit. It was just a teensy little tinge and after it got mixed in with the rest of the vial it was invisible. It would take a fair amount of blood to get a full vial to look red like that.

I always make some effort to make sure the flow is from the vial into the syringe and not the other way around. One way to help make sure that the pressure inside the vial is not less than atmospheric pressure, is to purposefully inject some extra air into the vial when using a brand new syringe. What I would typically do is pull the plunger out completely then stick the needle in the top to “equalize” pressure to atmospheric. Then I would run 30-100 units of air into the vial using the new syringe. It’s pretty easy to put 100 units of air into a nearly empty vial but not so easy to put 100 units in to a nearly full vial.

I found that if I reused a syringe one or twice, the tip would be deformed enough that I could tell it wasn’t sharp. I pretty much stopped reusing them after a few bad experiences. I never had any blood go into the vials but there is a good explanation why that never happened: I always pulled back (except for one, near-fatal mistake) prior to injecting, and if I saw any blood I’d discard and draw up a new syringe. Another thing I stopped doing was injecting thru my clothes on occasion. It always burned, from going thru clothes. Don’t know why, but it always hurt.

I almost always go through clothes. Today it seems odd to pull up my shirt of drop my pants (but on occasion I will especially when wearing white clothes).

And while I don’t re-use syringes nearly as much as I did 20 years ago, I still do it all the time. Maybe I use bigger needles and the change due to dulling less (I never was a fan of the super skinny needles).