Recently got my latest prescription of Humalog. Probably going on a week. But my blood sugar has been in the 300s every day since starting on it. Today is Saturday and I started using the new pens on Wednesday. Nothing seems to help lowering it. I am not eating anything out of the ordinary.
Was wondering if my insulin had gone bad? I tested another pen and got the same results. Or maybe something else? I am totally confused right now. I am only worried that I might go into hyperglycemia and land in the hospital. Obviously I can’t talk to my endo until Monday, and I really don’t know what I should do.
Could you go to the pharmacy and express your concern about the insulin and exchange some of the pens? Or, buy a vial of insulin out-of-pocket and inject it and see if that works better than the new pens you started on Wednesday?
For the time being, I guess I’d increase my corrections and watch out for lows if the extra insulin just starts working.
Also, have you tried the endo’s office? Is there no one covering and returning calls?
Sorry if all these suggestions are stuff you’ve already tried but I thought I’d put it out there in case. Good luck
HeyTnyc! Thanks for the suggestions. I actually went and bought a vial out of pocket this evening and my blood sugar corrected within an hour of injecting. Definitely something wrong with my other insulin.
My endo is out of her office right now due to maternity leave and the staff take their precious time to follow up. Plus they don’t have an emergency contact over the weekend.
I will have to wait till Monday to get this fixed. Oh well.
Thanks again for the ideas
That’s really surprising. I’ve used insulin that is expired, and even insulin that got hot in my car and it has always worked, so this seems like a major issue, maybe a manufacturing issue.
It’s times like this - and they do happen (I mean gazillions of insulin vials/pens are maufactured, there’s bound to be some bad ones) that make me wish that there was some sort of reagent strip that showed problems with insulin. It could be as simple as having those strips at a pharmacy, The pharmacist could perform the test and then replace the bad insulin. Having the oharmacist perform the analysis would “legitimize” the claim, and the pharmacist could get reimbursed by the insulin manufacturer for providing the replacement insulin.
Like Timothy, I was a little surprised since I believe insulin is exceptionally durable but I wonder if it’s that insulin in pens is more fragile…I’ve only ever used vials because I switched to a pump before pens were as prevalent as they are now.
Actually wondered that myself. I have been a diabetic for 8 years and have never had a problem like this before. My endo said she couldn’t do anything about it and my health insurance won’t replace it so I’m stuck paying for it for this month​:roll_eyes:. I have continued trying it to make sure it was definitely not working. I have been careful with what I eat and have exercised regularly and I still go high without cause. The only thing I can figure is that the insulin is bad. But I can’t really be absolutely certain.
The fact that the vial of insulin you bought lowered your BG where the new pens didn’t seems like pretty strong evidence if not absolute proof that the pens are bad.
Incredibly unhelpful on the part of your doctor. That must be so exasperating. I hope you can buy enough good insulin to last the month and throw the bad stuff away.
I agree I wish there was some test that could be done to see if the insulin is effective and also to monitor if the site has just been over used. I am on MDI, 5 shots/day, and when I first start a new vial, my BS tends to be high for 24 hours.
What are the changes that occur in insulin that manufacturers state only good for 28 days? I know after 46 years on insulin, back in the day, I would drain every molecule out of a vial.
One thing to always remember, when we have to use something we can’t do without, stock pile! Most endos are willing to write our prescriptions for a generous amount just in case. So calculate what is the worse case scenario. If you know you have to use double the amount right now to make it work, ask for a doubled prescription. I realized how valuable it was to do so when I dropped a vial of Lantus early on and it cost $80 to replace it, because the insurance would not cover that.
It’s invaluable for several reasons. When you get sick, you use more, when you switch doctors there can be delays in getting a new script, when you move, switch jobs, or when you drop and break a vial.
Humalog will replace “bad” insulin. But it is/was tedious. This was years back. I had to call and say all the particulars, then a message had to be left for the person that would handle it, then I had to repeat all the particulars. It all took time. Then they sent a coupon for a free pen etc to the pharmacy of my choice. Then in my case because I get mail ordered a 3 month supply, I had to have a script from the doctor written to the pharmacy to pick up the one new box.
The doctor can write you a new script, but it won’t matter because the insurance won’t cover above the amount needed. Some doctors have samples they can give out when needed. But that depends on the doctor. A past endo of mine used to have a huge supply from all the vendors of samples weekly. But she was a type 1 herself and knew the foibles of being a type 1. So really the solution for future issues is to keep plenty of back ups available. I like a 6-12 months supply myself.
When I switched from Novolog due to insurance changes to Humalog, my numbers went from my normal 187 to 300’s. I called the Endoc Specialist and then began to consult my PC describing what was happening. The Endoc std that Humalog worked faster, which did not solve the issue. I began to notice however that when I ate green vegetables, yup I said green vegetables like broccoli, the Humalog worked quickly and actually too quickly. I actually ended up taking the lowest dosage I could perform which was 2 units.
Since you say month I assume you picked it up at a retail pharmacy. Print out your CGM daily graphs, mark it up with the doses from the pens and the label the doses from vial. Go back to the pharmacy with the pens and CGM printouts. Ask to speak with the pharmacist regarding your medication. Don’t engage with anyone except the pharmacist. Tell the pharmacist the insulin doesn’t work, offer to show the CGM graphs and ask for a replacement box of pens. They’ll say no, ask again at least two more times.
If the pharmacist refuses to help file a complaint with your state board of pharmacy.
Then call the Lilly Diabetes Solution Center for a solution like @Marie20 described. Note that when you go back to the pharmacy take the pens and ask them to dispense a replacement using the coupon that way you don’t need a separate prescription. If the Lilly DSC can’t help call Lilly corporate and ask to leave a message for the admin assistant for Patrik Jonsson, President of Lilly Diabetes and Obesity.
As a T1D that also relies on this stuff to stay alive like you I’m shocked you got a bad box but also respect that your time is valuable and maybe it isn’t worth chasing a replacement. If so maybe just fire off the board of pharmacy complaint and call it a day.
Thank you all for your advice. The past week has been frustrating to say the least. I have a friend that is a pharmacist and he said to do what Spdif recommended so I will be starting that Monday morning. Wish me luck!
Kym-Kym you are also correct. I used to be on Novolog but insurance change put me on Humalog as well. I have landed in the ER only twice due to diabetes, and starting on Humalog was one of those times. I had taken a dose for my lunch. However, my BG was already on the lower end of the acceptable range and a wee bit later I blacked out. That was back before I had a CGM and was still learning management skills. Diabetes is an adventure! You never know what might be around the corner.
Marie20 I do need to stockpile. I will have to have that conversation with my Endo here soon. In fact if I had that this wouldn’t have been a problem at all. Thank you for that advice
A few years ago my blood sugars starting going thru the roof. Increased my bonuses and basal. Stopped eating high carb foods. My daily insulin usage doubled. It was a serious struggle. Switched from name brand humalog to generic lispro. Helped slightly. My endo assumed I had insulin resistance. This summer I changed to lyumjev. Holy cow my daily insulin usage is almost back to where it was before all this started. I can eat carbs again. I feel “normal” again. I’ve thought back to when this all started and it was when I had to switch to a new mail order pharmacy. Might be a coincidence, might not.
There’s usually no problem using insulin well after the 28 days. Like, months after. I think they just came up with a number that they felt confident guaranteeing it for. I doubt 28 days has any deep meaning involving chemical processes other than the fact that I suppose insulin, like most things over time, is decaying/losing potency but really not to the extent that it would be noticeably affected in 28 days. But, that’s just my experience plus stuff I’ve read others say. It may be different for some. And maybe there’s someone with a background in chemistry or pharmaceuticals(which I don’t have) who can explain that something big happens on day 29 but it seems far fetched.
It’s very odd that NEW vials are less potent for you. Might it be a matter of temperature? Straight out of the fridge vs room temp?
Plus they don’t have an emergency contact over the weekend.
But I can’t really be absolutely certain.