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Long Lost Member
iankapros
Total Posts: 1
Registered on: ‎03-03-2010

When To Refrigerate Insulin

Just out of curiosity, why do you need to refrigerate unopened bottles/vials of insulin, but once they are opened and being used, you only need to keep them at room temperature and not in the refrigerator?
Long Lost Member
n3qe-tim
Total Posts: 377
Registered on: ‎11-01-2009

When To Refrigerate Insulin

I think the idea is, after you start using them, you will use them up in a month or so, and they should be good for a month at room temperature.

Of course doses vary and there have been times when, for example, a bottle of NPH would last me two or three months. At other points like when I was a teenager I was taking probably almost 100 units of NPH a day and would go through several bottles in a month. So in this case YMMV a lot because doses vary a lot!

Some of us have experienced some discomfort injecting cold insulin and that might be a reason they recommend keeping it out of the fridge.

What I do:

I open a new bottle or Humalog and a new bottle of Lantus once a month, keep it in the fridge for the next month while I use it, then it goes to my backpack (unrefrigerated!) for a month in case I need some extra while on the go. After it's been in my backpack a month I try to throw it out although in some cases I've accumulated some old unknown-how-long-opened bottles there.

Tim.
Super Advisor
leehr
Total Posts: 2,182
Registered on: ‎11-01-2009

When To Refrigerate Insulin

To try to answer your question about insulin storage..... I do not really know for sure but this is my thought for now.

to maintain an average storage temp is probably one of the reasons for unopened vials? After 28 days it is strongly suggested that we discard the vials; again potency begins to lessen after vial is opened to oxygen so say the pharmaceuticals? I do not believe it has to do with their wanting us to buy more insulin; I believe it is based on research and trials.

Then the open vials stored at room temperature. Well, for most of us this is possible but for some of us it is not! I am one that had always thought I had to keep all my insulin refrigerated, open or not. However, when I had a trial Omnipod pump for 4 days the insulin was in the reservoir of my pump and it worked just fine! So much for that theory at least for me!

Also, keeping the insulin at room temperature may make it more comfortable for injection? Once the vial is opened I have been told by the pharmaceuticals, that its potency does begin to lessen over the 28 days but not enough to harm us. However, I have had vials opened only 14 days and had to discard; I was sent a replacement. Refrigerated it will last until the expiration date unless opened! Also the printed info says even if not opened and unrefrigerated, it should not be used after 28 days!

It also may depend on the climate where we live?

So, as is mostly the case, perhaps it depends on the individual's metabolic system as to what is best about storage of insulin and the climate location.

I still maintain that to keep unopened vials refrigerated (not frozen as it will destroy the insulin), is a good idea! If we do not do we have an legal standing by not following the written instructions? Don't know but do not want to chance it!

Joan :-))
Type 1 Diagnosed Nov 1957
MDI: Humalog and split dose Levemir
Ratio: 1: 16, 18, or 20 daily



* Type 1 Diagnosed for 56 years as of Nov 2013
* 50 Year Type 1 Medalist Award from Joslin Diabetes Clinic (Harvard Medical School)
* Medtronic Paradigm Revel 523 insulin pump as of March 2011
* Insulin: Humalog
* Food Allergies: milk, yeast, corn
* Hashimoto's thyroid disease
* A bit of arthritis
* One kidney due to benign Angiomyolipoma.
* Volunteer Community Disaster Co-Coordinator
* Hobbies/Interests: Wildlife Naturalists, artist, gardening, music
Long Lost Member
denise3099
Total Posts: 67
Registered on: ‎11-02-2009

When To Refrigerate Insulin

Unopened insulin needs to be refrigerated so it will last until the expiration date. One you open it it's only good for a month anyway so you may as well leave it out--since you only have a month to use it the refrigeration isn't an issue. You introduce air and possbily bacteria into it and it starts to degrade, refrigerated or not. Basically once it starts to degrade, by either warming or opening, you have about a month to use it.

Plus, insulin gets air bubbles as it warms up so you really have to keep it out if you are pumping or as it warms you'll develop air bubble in your resevoir.
Non-D mom to dd, age 8, dx at age 4.
Super Advisor
leehr
Total Posts: 2,182
Registered on: ‎11-01-2009

When To Refrigerate Insulin

Dennis we mostly agree but you failed to mention that climate and the individual has everything to do with how insulin helps us! Yes, of course, once opened insulin potency may or wil be far less effective after the 28 days but -- I have used both Humalog and Levemir up to 35 days with very good result; especially when my daily test results were very good. If my test results were a bit too high the opened vial does not last me but 20 days. There is documentation that proves a high BG result takes longer to bring back to target; does room temperature or refrigerated make a difference! I don't know. Some of us may find that the cold insulin stings or some such unpleasant feeling while other find no difference at all!

It all depends - on many factors.

Joan
Type 1 Diagnosed Nov. 1957
MID: Humalog & split dose Levemir
Ratio: 1 to 16, 18, or 20 daily

* Type 1 Diagnosed for 56 years as of Nov 2013
* 50 Year Type 1 Medalist Award from Joslin Diabetes Clinic (Harvard Medical School)
* Medtronic Paradigm Revel 523 insulin pump as of March 2011
* Insulin: Humalog
* Food Allergies: milk, yeast, corn
* Hashimoto's thyroid disease
* A bit of arthritis
* One kidney due to benign Angiomyolipoma.
* Volunteer Community Disaster Co-Coordinator
* Hobbies/Interests: Wildlife Naturalists, artist, gardening, music
Long Lost Member
denise3099
Total Posts: 67
Registered on: ‎11-02-2009

When To Refrigerate Insulin

Definitley where you live I think will have a lot to do with it--i think leaving a bottle of insulin out in 98 degree whether for a month will help it degrade faster than "room" temp of say 70. You leave it in your car and you'll cook it. You freeze it and it's ruined. Generally I opened a new bottle at the first of every month, just so I'd remember, so that was 28 to 31 days. I never noticed BAD numbers at the end of the month but I often noticed that a new bottle of lantus had a little kick to it. It doesn't just stop working at day 28 but gradually over the month wears out, so that bs was a little lower with a new bottle. If money was the issue though I would keep using it until i noticed it wasn't working well and then discard--I don't think it's unsafe, just not as effective as new.

Also, someone on another board mentioned that if air helps to degrade a bottle then it would make sense that the more air you put into the bottle the faster it would lose it's effectiveness. So if you had a high daily dose, you'd see a difference faster than if you used less, and put in less air, each day. Makes sense but I can't verify this. Personally, I store unopened insulin in the fridge and used a fresh bottle of lantus every month, when dd was on mdi. Once it's open or warmed, I discard after about a month. And I never fill a resevoir with cold insulin--you will get air bubbles. My advice is always to try it and do what works for you. Once your numbers start going up, open a fresh bottle--you might have gotten a bad bottle that wasn't stored correctly at the pharmacy. I've bought milk that was bad even before the expiration date.
Non-D mom to dd, age 8, dx at age 4.