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1

So earlier this week, I got up in the late morning with my husband and went out for breakfast. I dutifully took my insulin once I had decided on what I was ordering, and had breakfast. Later, at work, due for my next injection, I realized that in my just-woken state, I had not realized that I had depleted my store of insulin and needed my husband to bring me some.

It took him just over an hour (my BG was not happy about that). I took my insulin and strangely enough, my BG was higher post-injection than it was before hand. So I took another dose, to bring it down. For the most part, my BG didn't skyrocket, the way I would expect it to not taking any insulin, but it didn't come down either. It stayed either about the same or was a few mmol higher than it was before the insulin. I began to worry. I did not eat a snack. After multiple tests and injections, after 18 hours it was still floating between 9-15mmol. I think I took nearly 100 units (which normally probably would have killed me) without eating and my BG was still almost 13mmol.

Anyhow, my husband had told me I was on my last vial so I took myself to the pharmacy and got some more, though I had sworn I had more than that left. When I put it in the fridge, I discovered that as I remembered, there were three vials of each insulin still in there from the last refill. And then it dawned on me. I used to take Lantus and Humalog, which now that I have extended coverage, I think I can switch back to. (I could not afford to take it for awhile). When I was taking it, I'd held onto a single vial of Toronto that had expired, so that I'd know what the box looked like when I got it from the pharmacy. The insulin my husband brought me had expired in 2009. So on one hand, I felt like an idiot, and on the other, was truly relieved to discover that the high BG was the insulin and not me. Expired insulin has been trashed. I won't be doing that again.

Funny thing was, it did work. It took a long, long time, but I hit hypo at 4.1 for a really brief period of time. I had to take a lot (A LOT!) of it to make it effective, and it was effective for a much smaller window of time. So in an absolute emergency, if you have a vial of expired insulin and it's all you've got, it won't do you for long, but it at least kept my highs relatively consistent, and it did eventually bring me down to normal. I'd expect to go through twice as much of it as normal though. I don't recommend it. But in a zombie apocalypse situation, if it buys you time, go for it. :P

Switched to my new insulin and everything is back to normal. I've been between 4 and 7mmol for two days now, except in the morning, my BG has been elevated. I woke up at 5:30 this morning with the sweats really badly. But I got it managed pretty quickly, so everything is okay. I slept through my nighttime snack.Odd, though. I haven't been up this early voluntarily unless I was actually just up this late. Or due to be at work in the morning. Today I am neither, and it actually feels pretty good.

I've been cutting way back on caffeine. I've finally admitted that caffeine is raising my between-meal blood sugar and stopped drinking it for the most part. Today was my first cup in two days. Of course, that means I've had a really disorienting migraine for the last 48 hours or so. I've been drinking decaf. Coffee flavor will get me through. It will get easier. :)

2

I have a question… can you get insulin without prescription in Canada?

But good to know that expired insulin can still have some effect!

3

This is a valuable message you’ve given. Expired insulin DOES gradually weaken in potency (I wouldn’t even attempt to calculate how much, and how much to increase your dose as a result), but if it’s enough to keep you out of DKA, then it still can still be beneficial.

But I haven’t got a clue how you plan to give up caffeine. That must be really tough!

4

Sorry to take so long getting back to you guys! Anne, you can get insulin over the counter in Canada. Here, any medication that a person requires to stay alive can be purchased without a prescription, but it isn’t cheap. Without a prescription, BC Medical doesn’t pay for any of it (here we have manditory medical programs- they sign you up at birth and pay your premiums until you turn 19). The Lantus and Humalog I used to take were just about $200 every 15 days. I was spending $400 a month on insulin. Test strips were another $100 for a box of 100, which I had to make last the month. Until I got extended medical, I was paying almost $10,000 a year for my diabetes care.

If my memory is correct, BC Medical and Pharmacare didn’t cover my diabetes meds because they’ve considered diabetes a “self-inflicted disease” here, and there is very little distinction between type 1 and 2 as far as they’re concerned. There were many times I could not afford insulin and was half-dosing (which kept me alive, but sick all the time) and the hospitals turned me away and told me to come back when I was acute DKA.

There is also a much smaller market for diabetes care here. There are only two or three brands of meters, and the diabetes sections of the pharmacy are very small and only carry about a dozen different products or alternatives, most of which do the same things. The only big diabetic section I saw was in the Real Canadian Superstore. They had a lot of sugarfree things. :slight_smile:

5

Scott E- yeah it was not an intentional experiment, but I am glad it at least had enough effect to keep me out of trouble. I’ve felt DKA coming on after a day without insulin (I’ve had it before, and unfortunately become very close again due to poverty and the inability to get insulin).

I used to be a big drinker of energy drinks. Drinking them brought down my coffee consumption significantly. I used to drink more than four pots a day, but over the years coffee began upsetting my stomach, and I suffered several ulcers. I began drinking energy drinks to sate my addiction, and preferred them because they were cold and I could get them sugar free. I denied the fact that caffeine raised my bg for years. But I clearly saw my numbers, even with impotent insulin, rise after having coffee.

First few days was tough. I think I drank my weight in decaf, and admittedly, I still drink diet soda. But I had a raging migraine for three days, and suddenly I’m tired a lot earlier than I used to be. I think this is a good thing. I just need to give myself more time to get used to it.

6

Wow… and I thought the Canadian healthcare system would be better for people with diabetes than the American system. (more fair, anyway). Boy was I wrong! This is a real shocker to me.

7

The quality of diabetes care, I’ve found, varies by the individual. And furthermore, I gather it used to be a lot better until herds of people began developing diabetes. But yeah, its a huge misconception here that we can just walk in to a treatment center and walk out with whatever we need. When the hospital turned me away for insulin when I had no job and no money and no insulin left, they literally told me “This isn’t a soup kitchen. Come back when you’re in a coma.” I envy other people a lot, because their experience was so different. Some people caught it immediately and were diagnosed as minors, and received the government coverage they were entitled to. Whereas, I was sick for most of my adolescence and went undiagnosed (despite a growing number of symptoms, one of which was kidney failure) until I was just over the age of coverage qualification. Because I was diagnosed so late, doctors did little more investigating than telling me I was type 2. My first diabetes class, everyone was twice my age, and obese, and I was 19 and a stick. I felt really alone at the time because I fell through the system. Sadly, that happened to a huge number of people in my age group in the last several years, and most of them died. The Canadian Diabetes Association is trying to have my age group advocated for coverage, because so many of us were diabetic through childhood and didn’t know and the mortality rate is so high.

8

This is a tough story to read. I’ve always been shocked by the Canadians who post on here and say that everything is free. I live in Ontario and it’s not free here either (although the government just approved pumps for T1s). When I saw Michael Moore’s film I was shocked! So many people in Canada fall through the cracks. I hope you are soon able to get the treatment you need. What has happened to you is just so unfair! :frowning: Joanne