I worry about this too, as I don't always finish my Novolog pen in 28 days. I just started writing the date I start a new pen in my BG log, so in a few months I will be able to tell if there's a pattern in which the insulin becomes less effective at a certain point. I am also keeping my pens in a frio case at all times during the hot weather- it isn't as cold as the fridge, and it keeps the insulin at a pretty consistent temperature. I hope this is okay to do! I know you said you would prefer not to switch insulins (and if you are happy with them, I totally understand), but FYI Levemir lasts 42 days once opened.
thanks Rennie :)
great idea to keep the written log- I'm going to do that too... I have marked the finish date on the lantus pen and on my calendar for both pens- I should put it in my phone too. I'm going to look into the frio or another case- I think the reason they say not to refrigerate after starting a pen or a pen refill is that this can clog up the mechanism or something maybe, although I haven't had any problems with that as far as I know. clearing the pen or with novpen, they say to clear 19 units into a cap if something seems like it isn't working properly, could let you know if there is a problem or not. I also heard that cold insulin can be painful to inject although I didn't notice much of a difference. I think that was it- Levemir. There was an ad at my endos office on their tv/commercial thing. I'm going to read about it and see if I would consider that one because I think Pendiq can use their refills. I'm also trying to find a small fridge just for the insulin.
They don't do that because they make more money by selling larger quantities than is necessary and then telling the patients they have to throw it out after 28 days. They have billions of colonies of ecoli bacteria manufacturing our insulin and really all they have to do is collect it purify and package. I don't know if you realize the billions of dollars at play here. Of course it would make a lot of sense to make smaller pen amounts for people using less, but that would cost the big pharma companies money. And they're not big fans of missing out on their piece of the diabetic pie. JMHO
How do you get your top 10 list to post in your reply ? I was looking for my discussion about How long does Lantus last and found it but I could not figure out how to copy and paste ?
Go to the web page that you want to like to and copy the URL. Then go back to the page where you are posting and select the tab with "link." Then simply paste in the URL. Send me a msg if it is not clear and I will talk you through it.
https://forum.tudiabetes.org/topics/do-you-really-throw-out-lantus-or-humalog-after-28-days Meee, this is the discussion I was talking about. Thanks bsc for the information on copying/pasting.
You are a fast learner and now are extemely dangerous.
Hi Clare, I was just recently diagnosed and I didn't know all that much about diabetes or all of the politics involved, no one in my family has been diabetic that I know of yet. Yes I realize the money at play with medications and medical care in general, but I thought it might also be because most people are on much higher doses, but then I guess there are probably many at lower doses too.
And I have noticed insulin has not gone generic yet and it's way too expensive. Would it really cost them that much in profits though if people weren't throwing half used vials/pens etc. away? I wonder how much more money they're making by doing that, it would be interesting to see the actual cost breakdown.
It's sad if you're hunch is correct. If I could switch to a smaller amount for now I would.
That is interesting that it's manufactured by ecoli bacteria, I had no idea about that.
I noticed a lot of people don't throw out their insulin.. wonder what types they're using- I will have to back and re-read.
All the new insulins out today are are called insulin analogs. They are derived from some hi tech maneuvers with rDna and ecoli. But they are not exactly the same as the insulin you would produce if in fact you still did. That's how they can engineer insulins like Lantus or Levemir that lasts longer and insulins like humalog and novolog that are rapid, short acting insulin. They just change a few amino acids in the insulin sequence and it changes the action. Back in the "olden days" I started in 1975 using insulin that was basically ground up pig pancreases. The good thing about it was it was still very similar to what my own body would have made if my islet cells weren't destroyed. The old insulin still contained C-peptide which is thought to be a neuro protective component in insulin. The insulin analogs do not contain any C-peptide.
And yes there is a lot of politics involved in D and pharma. If you look at some of the other discussions here, one was "will there be a cure in my lifetime ?" It was a bit disheartening, but all too true, we are a money machine to companies like Abbott, BD, MiniMed, Omnipod, Eli Lily, Novo=Nordisk, Sanofi Aventis. They all want their piece of the pie so there is no profit in a cure. And yes it would really cost them too much if they let us use insulin until it was well past the 28 day time period.
I too have no one in my family with diabetes, so it has been a learning experience from day 1. I recently called my Mom to thank her for not being soft on me when I was first diagnosed at 14 years old. It has made a big difference in my life, she did offer up, "Clare I did give an orange an injection" to which I replied, yes, but you never gave me one did you ?
Wow, this is interesting! The idea of animal-derived insulin is pretty weird to think about, but it sounds like there were advantages to it. I wonder if there's a difference in how the synthetic stuff will affect us in the long run.
Richard is a 50+ year veteran of D and he posted a little while ago about the benefits of C-Peptide and how he felt that the complications he has have come about as a result of the lack of C-peptide in the insulin analogs. There is a pharma company
www.cebix.com/ in California doing a clinical trial in patients with neuropathy and using C-peptide along with their insulin therapies. "Recent results indicate that proinsulin C-peptide, contrary to previous views, exerts important physiological effects and shows the characteristics of a bioactive peptide. Studies in type 1 diabetes, involving animal models as well as patients, demonstrate that C-peptide in replacement doses has the ability to improve peripheral nerve function and prevent or reverse the development of nerve structural abnormalities. Peripheral nerve function, as evaluated by determination of sensory nerve conduction velocity and quantitative sensory testing, is improved by C-peptide replacement in diabetes type 1 patients with early stage neuropathy. Similarly, autonomic nerve dysfunction is ameliorated following administration of C peptide for up to 3 months. As evaluated in animal models of type 1 diabetes, the improved nerve function is accompanied by reversal or prevention of nerve structural changes, and the mechanisms of action are related to the ability of C-peptide to correct diabetes-induced reductions in endoneurial blood flow and in N a + , K + -ATPase activity and modulation of neurotrophic factors. Combining the results demonstrates that C-peptide may be a possible new treatment of neuropathy in type 1 diabetes." This is a copy of the abstract from a recent paper.
I'm going to reply more later but wanted to ask if you have heard of giving c-peptide supplements/shots? I had read about what you're saying here about the protective factor they have for preventing complications.
Thank you very much
I know that you think you are wasting units by priming, but if you are dosing small boluses and need 1/2 unit accuracy, you really should prime. If you don't prime, then much of the first unit will simply go towards filling the needle. This results in an innaccurate and highly variable dose.
To assure yourself of this, just test it. Get a glass plate, put on a new needle, dial in a 1 unit dose and inject it slowly into a drop on the plate. Now dial in another 1 unit dose and inject it next to the first drop. Are they a different size? Did you even get any insulin in the first drop?
ps. I think all insulin expires after 28-30 days once you open. I use Humalog and it is 28 days.
I think what may actually happen once the clinical trials are over is Cebix or some other pharma company will partner with the insulin companies and start adding c-peptide to the insulin. At least it is an entirely natural product that is not synthetically derived and could be beneficial onthe neuro side of things.
I use the Levemir flexpen, it's instructions say to use it only 4 weeks. If you use a Levemir vial with a syringe, then it will last 42 days once it is opened or removed from the fridge. But a vial is 10mL, more than three times larger than a 3mL pen.
I agree completely bsc I always prime before I shoot up (sorry inject)
thanks bsc, I'm going to try that. I wonder if I have been using lower doses and haven't even realized it... I guess that would mean I'm still producing my own insulin too, which I had other signs of also, and or the new diet is helping a lot more than I realized. I will let you know my results.
It has also been a matter of time as it takes so long to do all this stuff so priming takes that extra bit of time too. I notice after an injection that insulin just keeps coming out of the needles in little beads/drops.
My endo had said it isn't really necessary to prime every time but I was using much larger doses then and I guess it makes less of a difference that way.
I think he said to prime with 2 units, do you use only 1?
I hope they do that if it turns out to be shown to help, but it will probably be more expensive then as opposed to the other insulins without it.