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Established Advisor
legion681
Total Posts: 600
Registered on: ‎07-05-2011

How do you know if insulin has gone bad?

This is a pre-emptive type of question, as my motto is "hope for the best, prepare for the worst".

I know that insulin is good for 28 days out of the fridge and it ought to stay in between 36 and 86 degrees.

That said, here's the simple question: is there a way to tell if insulin has gone bad before you inject it?

Thanks in advance for the help and answers!
Name: Al
Location: Massachusetts South Shore
Diabetes Type: 2
A1C results: 17 (at dx), 8.3 (2 months after dx), 5.2, 5.2, 5.1, 5.2 (<-- latest 10.10.2012)

*** Boston Bruins - 2011 Stanley Cup Champions ***
Long Lost Member
arthur8956
Total Posts: 40
Registered on: ‎11-30-2010

How do you know if insulin has gone bad?

Insulin is pretty resilent stuff.  I have a pump and it carrys about 4 days worth of insulin at body temperature.  I have had it at body temperature and put it back in the frig.  and then taken it back out for use.  I have never had any trouble.  The obvious ways of telling if it's bad, if it turns cloudy, by checking your bg level 30' after a shot to see if there are any results.  I like you make a concerted effort to keep it only for about 28 days, but the drug store says it's good if refrigerated for at least 6 mos..  I will be interested to hear others views on its utlitarian nature.
Established Advisor
legion681
Total Posts: 600
Registered on: ‎07-05-2011

How do you know if insulin has gone bad?

Hey Arthur, thanks for the reply.

I found out more here: http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7247
and I think I can work with these guidelines.

I know that if you keep it refrigerated, insulin ought to be good at least until the date stamped on it (the batch I have now, If I remember well, says it's good till sometimes in 2013). However once you keep it out of the fridge, days start counting. I have been told by everyone (nurses and doctors) that it needs to be thrown out on the 29th day, but the interesting thing I learned on the link I posted here above is that not all insulins are the same.
On that link different insulins go from as little as 7 days to as much as 42 days depending on which type.
When you say that your "drug store says it's good if refrigerated for at least 6 mos", what do they mean? I am kinda confused about their statement.
Name: Al
Location: Massachusetts South Shore
Diabetes Type: 2
A1C results: 17 (at dx), 8.3 (2 months after dx), 5.2, 5.2, 5.1, 5.2 (<-- latest 10.10.2012)

*** Boston Bruins - 2011 Stanley Cup Champions ***
trisha01
Total Posts: 6,354
Topics: 307
High Fives: 674
Blog Posts: 62
Solutions: 72
Registered on: ‎10-31-2009

How do you know if insulin has gone bad?

 



Trisha

IDDM (Type 1 Autoimmune) 30+ years ~ Currently using MDI & Minimed CGM ~
Check out my diabetes blog!

  All brittle means, is that one has great fluctuations, which is pretty much hallmark for Type 1's. Some more so than others. - me
  First light brings a new day, new hope, new wisdom, and a chance to start fresh again. - me

If everyone were dealt the same amount of cards, there would be no challenges in life. Challenges are part of life's lessons, to teach us to grow in all aspects, and to learn what we need to learn, to make it in this world. Life was not meant to be fair. -me



~ New Type 1 Info ~ Insulin, Test Strips, Lancets, and other meds ~ Kidney Damage Info ~


trisha01
Total Posts: 6,354
Topics: 307
High Fives: 674
Blog Posts: 62
Solutions: 72
Registered on: ‎10-31-2009

How do you know if insulin has gone bad?

Al,

Once the little cap comes off the vial of insulin, *they say* throw it out at 28 days. However, I've had insulin go bad at 15 days, and I've had insulin that worked just fine, at 6 weeks. Once you become more expereinced with using insulin, you will know when your insulin isn't working.

p.s. ... I use Novolog and Lantus.

Trisha



Trisha

IDDM (Type 1 Autoimmune) 30+ years ~ Currently using MDI & Minimed CGM ~
Check out my diabetes blog!

  All brittle means, is that one has great fluctuations, which is pretty much hallmark for Type 1's. Some more so than others. - me
  First light brings a new day, new hope, new wisdom, and a chance to start fresh again. - me

If everyone were dealt the same amount of cards, there would be no challenges in life. Challenges are part of life's lessons, to teach us to grow in all aspects, and to learn what we need to learn, to make it in this world. Life was not meant to be fair. -me



~ New Type 1 Info ~ Insulin, Test Strips, Lancets, and other meds ~ Kidney Damage Info ~


Frequent Responder
__bsc_
Total Posts: 621
Registered on: ‎05-26-2010

How do you know if insulin has gone bad?

I recently had an experience where my insulin was frozen (long story).  Upon close examination my NPH appeared normal, no change in appearance.  But it was ruined.  After two days and dramatic increases in my doses, my fasting blood sugars were high and it was obvious.  The Humalog was a different story.  I appeared to survive the freezing only partly skunked, I was able to continue using the humalog but had to essentially double my dose.  I ended up throwing out three NPH pens.

I only started insulin last December, this was a real learning experience.  Clearly, if your insulin showns "any" change in appearance, you should consider it ruined.  But from what I saw, freezing resulted in no change in appearance and the effect was not binary.  Rather the NPH dramatically lost potency and the Humalog lost about half it's potency.   I think most basal insulins are more fragile and tend to go bad faster.  But going bad may be reflected in an ongoing loss of potency rather than a sudden total loss.  That can be hard to see.

Super Advisor
Pam01
Total Posts: 2,207
Registered on: ‎11-02-2009

How do you know if insulin has gone bad?

I have trouble with my insulin in the pump going bad in the heat. I have used insulin vials and pens long after 28 days successfully.
Pam

Diagnosed Type 1 at age 16 months, over 45 years now
Minimed pump and cgm since July '09. Metformin (insulin resistance), levothyroxine(thyroid), losartan (BP)

I have traveled cross country, and to Canada, UK, Kenya, Mexico, Jamaica, Equador/Galapagos islands, and lived in Egypt for a year.
Established Advisor
legion681
Total Posts: 600
Registered on: ‎07-05-2011

How do you know if insulin has gone bad?

Yeah, I try to keep a VERY close eye on the insulin and not let it go bad.

However I wanted to know if there was a surefire method of knowing if it had gone bad before injecting it. So far, if I got it right, the only thing is visual cues and that's it, right?

One more question: if insulin has gone bad and for whatever reason one injects it by mistake, besides the fact that it most likely won't do what it's supposed to do, is there any risk of any bad side effect of any kind?

Name: Al
Location: Massachusetts South Shore
Diabetes Type: 2
A1C results: 17 (at dx), 8.3 (2 months after dx), 5.2, 5.2, 5.1, 5.2 (<-- latest 10.10.2012)

*** Boston Bruins - 2011 Stanley Cup Champions ***
trisha01
Total Posts: 6,354
Topics: 307
High Fives: 674
Blog Posts: 62
Solutions: 72
Registered on: ‎10-31-2009

How do you know if insulin has gone bad?

"One more question: if insulin has gone bad and for whatever reason one injects it by mistake, besides the fact that it most likely won't do what it's supposed to do, is there any risk of any bad side effect of any kind?"

Al,

As you are a new Type 2, you might get some higher numbers, and that would be all. However, those higher numbers could have very detrimental effects for we Type 1's, if we don't figure it out real quick like.

As far as knowing before you inject, just visual, and that doesn't count for all of the insulins. Some of them are cloudy by design.

I don't see that you have any reason to be concerned, but it is good to ask questions, to further educate yourself.

Trisha



Trisha

IDDM (Type 1 Autoimmune) 30+ years ~ Currently using MDI & Minimed CGM ~
Check out my diabetes blog!

  All brittle means, is that one has great fluctuations, which is pretty much hallmark for Type 1's. Some more so than others. - me
  First light brings a new day, new hope, new wisdom, and a chance to start fresh again. - me

If everyone were dealt the same amount of cards, there would be no challenges in life. Challenges are part of life's lessons, to teach us to grow in all aspects, and to learn what we need to learn, to make it in this world. Life was not meant to be fair. -me



~ New Type 1 Info ~ Insulin, Test Strips, Lancets, and other meds ~ Kidney Damage Info ~


Established Advisor
legion681
Total Posts: 600
Registered on: ‎07-05-2011

How do you know if insulin has gone bad?

Hi Trisha,

First of all thanks for the info and answer.

However, when you say that for me, a type 2, "higher numbers" "would be all", while for a type 1 "those higher numbers could have very detrimental effects", you have me truly puzzled.

This because I believe that, for example, a bg of 500 is as bad for a type 2 as it is for a type 1. Wouldn't it do, in general, the same type of damage? Please explain.

Furthermore, when I was diagnosed when I was rushed to my hospital's ER and then straight into the ICU, my bg was 918, my blood ph 6.8, I had lost 40 lbs of weight in a week, I was completely dehydrated and I had DKA (I also discovered that at the hospital they did an A1C...the result was 17...then I didn't know what it meant. Now I know it means that my average bg for the previous 2-3 months was 430...not anything to joke about...). To put it simply, I was very, very close to death.
So...my diabetes doesn't seem to mind having detrimental effects on me, a type 2...

Name: Al
Location: Massachusetts South Shore
Diabetes Type: 2
A1C results: 17 (at dx), 8.3 (2 months after dx), 5.2, 5.2, 5.1, 5.2 (<-- latest 10.10.2012)

*** Boston Bruins - 2011 Stanley Cup Champions ***