For those of you who do not use a pump or a pen, how long do you use a bottle of insulin? All the info from the manufacturers says to throw it out 30 days after you begin using it, but I’m wondering what the general reality is out there.
Our daughter is two years old. She uses such a small amount of insulin, that there is no way she will use an entire bottle within the 30-day window, before the insulin “expires” or becomes “contaminated.”
She was dxd on Oct.6,2008, and so far we have thrown out 4 almost full bottles of insulin, 2 Novolog and 2 Lantus.
When I think about all the people in the world who do not have access to insulin, it makes me sick to throw it out. But I don’t want to keep using it, if it won’t do her any good anyway.
Is there a way to get the unused insulin to people who need it? Isn’t old insulin better than no insulin at all?
On a related note, is there any way the manufacturers could make smaller bottles, so there would not be so much wasted by people like us? I have a feeling that answer is all about money. Smaller bottles mean smaller profits to the manufacturers?? Maybe I am being too cynical?
Anyway, I would love to hear any and all thoughts and suggestions any of you may have.
Thank you so much. I am so thankful for this site.
I wish you all a healthy and happy New Year.
Tonya Homme
would it work to use the Novolog 3 ml penfill size ??..just a thought !..I am an adult pumper and use about 23 u daily , so do not have the same concern as you have with your little one . One suggstion ( not from a medical person ) I read on a Lantus blog : keep the bottle in the fridge , fill your needle ,return bottle to fridge , leave needle at room temperature , till is required. Bottle in fridge should last longer than 28 days …worth experimenting ???
Good luck .
Thanks for sharing your thoughts and ideas. I will have to check out the Novolog pen…I have been reluctant to try it because I heard you have to hold it in for 6-10 seconds, which can be kinda tough with a squirmy 2-yr-old.
Do you happen to remember how much longer than 28 days the Lantus blog said it would last?
We keep our Lantus in the fridge at all times, and return it to the fridge immediately after filling her syringe, so I wonder how long they think the Lantus is good for?.. Thanks again, Tonya
I used the last few drops from my vial today but i did not quite get enough for a full dose so I am not 100% sure if the effect was because of the slighly lowered dose or less because of lost potency. I just started on a new bottle today but I am willing to leave it say 31 days and try to see how the potency is.
An other approach may be to find a diabetic in your near proximity that needs a lot of Latus per day say at least 50 units or more and give him the bottle after you have used it 14 days and let him use the remaining balance. Similarily the high user would start a bottle for 14 days and then give you the remainder. Since a total of 2 bottles were purchase to satisfy both patients for the 28 day period. Without the arrangement a the person using the least would have had to purchase 1 vial and the person using the most would of have to have purchase 1.4 vials to cover his 28 day need. That would require a total of 2.4 vials instead of 2 for a saving of 0.4 vial. Then if you split this saving of 0,4 vial in two . The small user pays for 0.8 of a vial and the large user pays for 1.2 vial and it is a win win. Dont know what it costs in the states but this could be profitable and not too complex arrangement. Of course a larger usage by the high user would result even better savings.
I got told it can stay out at room temp for 30 days, and then after that it needs to stay in the fridge if you still want to use it. Just make sure you roll it in your hands when you take it out of the fridge to warm it up before you inject with it or it burns.
I have an unusual form of diabetes and also use very small amounts of insulin. My insurer won’t cover pens which is really frustrating, as I can make 5 pens (one order) last 5 months. But it costs me more than five times as much to buy the 5 pens as a single vial, so it’s a pain.
I have found the following helpful for keeping insulin alive longer than 1 month.
Keep it refrigerated on the lowest shelf in the fridge and only take it out when preparing injections. (Do not store it in the butter compartment or the door if it is a newer fridge with large door shelves. The vibration when the door closes can ruin the insulin). Check the temperature of the fridge to make sure it isn’t too cold as freezing also can harm the insulin.
NEVER reuse needles. I have tried all the techniques for reusing needles and they ALL seem to harm the insulin.
Don’t inject air into the vial for each shot until it gets hard to remove insulin, then just stick a syringe without the plunger into the vial to let the air in. .
After six weeks, if you see any unexpected increase in blood sugar, change vials. But as long as blood sugars are performing properly, you can use it. Also, when you start a new vial after using an old vial, dial down the dose a bit, just in case you have been using weakened insulin and increasing the dose a bit without noticing it. Often a new vial will be stronger than even a month old vial, so caution is always in order when you change vials.
Try Apidra. but only if your doctor thinks it appropriate I have found Apidra the one insulin that never fades out over time even when not refrigerated. I kept one Apirdra pen alive for 3 months last summer when I was eating very low carb and using little insulin and have yet to throw away a drop. The only issue with Apidra is that it is a bit faster than other insulins, so it may or may not be appropriate for children. It is the insulin a lot of people use in pumps because of its stability. I find it covers food better than any other insulin because it peaks at an hour, but that varies from person to person.
I have kept Novolog pens going until they were all used up (7 weeks) BUT I have also killed them by carrying them in my purse on warm days.
I have experimented with transferring insulin into a vial I purchased, but it went bad very fast. My pharmacist told me he thinks they do something special to the insulin vials to preserve it. If your pharmacy can order empty insulin vials for you, which are used for diluting insulin, you might try that. I have heard of this happening, and perhaps a compounding pharmacy could do it. My local ones won’t.
Hey Tonya,
I completely understand where your coming from! I was told by my CDE (also Type 1) that insulin refridged or not, once opened will last 28 to 30 days. After that, the insulin’s potency declines, and it becomes hard to predict how much you need to control your bgs. Since I just went on a pump, I was upset with having to waste half a vial a month, and having to pay a copay every month, when my flexpens lasted longer for the same amount of money. So I now pull my insulin for my reservoirs from my insulin pens. It works out GREAT! They come in a five pack and stay in the fridge unopened til I need them. There is also no injecting air into anything and I get 1500ml instead of 1000ml for the same price! I bet you could put syringes into the flexpens the same way.
Another option is to switch to Levemir. It lasts 40 days before it starts to degrade.
Tonya , maybe I did not make myself clear about the " penfill size " …I was thinking of drawing the insulin from that particular size( pen ) , rather than using the pen for delivery .
I googled " Lantus insulin size bottle " and found a blog " does insulin really last only 30 days " …I also noticed it being several years ago , that anyone responded.
I noticed some other folks , that have responded have some experience with Lantus …keep us in the loop , if you have found something that works for you !
Dear Tonya: Happy New Year. In response to you questions about not using all the insulin, I would very much think that ANYTHING that was opened and used by one person would NOT be legal to be used by another. There is a “contamination” concern. My Visiting Nurse cannot even take a pair of scissors or unopened dressings out of my house for use on someone else. You cannot return a used prescription to the store even in error. Sometimes, though, my pharmacist will take an UNOPENED prescription back if they made an error.
I would assume that, if the drug companies did make a smaller size, they would make a regular mint!! Smaller is probably more expensive and they, of course, pass the cost on to the consumer.
I am not sure of the expiration date thing. Ask your doctor or pharmacist. After all, I was told that insulin should be kept in the refrigerator but now my pharmacist says that it really doesn’t matter as long as it is at no more than room temp (room temp NOT being in the 80s) for 30 days.
I know of the frustration when I get a glut of supplies for testing and not being able to openly give them to someone who needs them. Like now, I’m kind of swimming in test strips and lancet drums for my AccuChek Multiclix. I am due to get another 3-month supply in about 7 days even though I told them to hold my last shipment!
My last bit of advice is to ASK A MEDICAL PROFESSIONAL. One other thing, maybe if you find a doctor going on a mission to a third world country, you could get them to take some of the insulin. Don’t forget, you DIDN’T hear it from me!
As a former Chemical Engineer I worry at lot about any mechanical action on a complex long molecule as insulin you wonder if like polymers used for flocculation they can be rendered inactive by being rolled up in a ball by too much turbulance. Jenny if you have any references to this I would gladly like to read then and show them to my Endo who is quite open mided but said nonsense to hydrodynamics being a problem. A collorary would be to discharge your syringue as slowly as possible because barreling it out a the speed of sound may also be unkind to the insulin.
you wonder if I am being cheap by drawing a double dosage from the vial injection half and storing the other half in the fridge until it is needed next day. What do you think, with Lantus could this be insanity?
great advice if you use a little per day but at 50 units more difficult. Plus I will forget to add air and will then swear when it does not come out.
Fast would be good for postprandial or whatever corrections. Will see if it is available in Canada.
Tonya, to echo nel peach, we draw insulin from penfill with a syringe and/or use with a pen tip. End up throwing out very little insulin this way. You don’t have to inject air into the penfill with a syringe - just withdraw insulin. Using penfills with syringes is how we were taught by our daughter’s diabetes team.
Cheers.
I’m an adult type 1 and I used 8 or 9 units of Lantus /day. I have the same problem: I used cartridge (with Autopen) and I throw it out just before 28 days. Why? Because of my experience: I tried one more week and my Lantus was not so good, my blood sugar was high. I tried 2 months and it was the same story, my blood sugar was high. I don’t put it into the fridge when I used it. I think laboratories could make small cartridges for little children or adults. Happy New Year!
I used to use insulin until the vial was empty, usually about 35-40 days, but I started noticing that my blood sugars would run higher towards the end of the bottle and that the insulin action seemed to be delayed - I would stay high for hours then crash unexpectedly. After talking to my CDE about this I found out that insulin begins to degrade as soon as the cap is removed from the vial and the rubber is punctured, and the insulin will be good for ONLY 28 days, refrigerated or not. Maybe putting the vial in something completely airtight it would slow the process down, but I wouldn’t count on it. FWIW, I currently use Apidra and usually find that its action usually starts to diminish after only about 21 days.
I don’t have any references about vibration ruining the insulin. Someone mentioned this to me online years ago and since our fridge door really quakes when it is closed because there is so much stuff on the door shelves and it is so poorly built I figured it must be the explanation. I’ve done much better now that I moved the insulin.
I have never had a fridge that vibrates this much. If you don’t hear bottles and jars rattling when you close the door, it may not be an issue. I have met many people who keep insulin in the door.
The problem with drawing a double dosage is injecting half a dose. It is much too easy to overdo the dose. For me, since i’m sensitive to 1/2 a unit extra that isn’t an option.
That is really odd about your Apidra degrading. Mine has stayed really constant for as long as I need it and I have used every cartridge down to the last drop. I only use 2 or 3 units a time and I’m very sensitive to changes in potency.
I have had to throw out vials of R and novolog pens because of the degradation problem, so this has really surprised me.
I wonder if it may have something to do with how well the pharmacy stores the insulin before it gets to us. I have just bought a vial of Levemir which is acting just like the last vial did at the end of it’s 5 weeks which is really annoying. My doctor has also given me samples from time to time that are dead, though other samples with different date stamps are fine.
