I have been using lantus for my basal and novolog, both in pens- I'm now using the novolog junior pen with 1/2 unit doses.
The packaging says they will last 28 days, I think my endo told me 30 days. I noticed that with my last two pens maybe the effect was wearing off as I had some higher bg, but I'm not sure, in any case I stopped using them and started new pens including the novopen with a new 300 ml vial.
I'm using very low doses currently at 9 units basal and bolus of 1-2.5 for meals usually so I'm going to end up wasting a lot of insulin if I have to start a new pen every 28 days.
The info also says not to refrigerate pens.
I'm wondering how long you have found they last and if you refrigerate and if that helped them last longer without problems?
I always keep all my pens in the refrigerator until I start using them and they have quite a long life, assuming until the expiration date on the pen. Once they reach room temperature the clock starts ticking and returning them to the fridge won't stop or slow the clock. Do they offer a smaller dose pen? That would be your solution but I've never seen that. I was told by novolog that the life is 28 days.
How about this? :) Could you get a novolog vial and when it's empty, empty half your pen into it and keep in the fridge until you need the rest?
I keep them in the fridge until I use them but I had put them back in someimtes after starting one until I read your'e not supposed to do that.
I think the vial idea is a great idea, I had been thinking about something like that too but the literature says don't inject the insulin into anything else, do you think that would affect the insulin? I guess if I can get an empty vial I can try it and see what happens, it can't be any worse than throwing away nearly half a 300 ml pen. thanks :)
I forgot to say, I'm not sure if they offer a smaller dose pen, but I think they are all 300ml maybe. I thought this would work out ok for lantus as I was on 30 units when in hospital and then reduced to 22 when I got out, but then I started honeymooning I guess and my dose was reduced a lot more due to hypos. I'm going to call the companies to see. I have thought about using pendique also, but you can't use novolog refills with that for some reason and I'm not sure if I want to switch insulin right now as I'm just getting used to all of this and to these insulins.
I started a discussion about this on the Type 1 forum. I got 38 replies. If you look for a discussion "do you really throw out Lantus after 28 days" or something like that you might be able to find the info there. Or you can just go to my page and open my discussions ? I don't know how to copy a discussion and paste it here sorry.
thanks clare, I will look for that discussion :)
With my insurance, I only pay the co-pay. If I used twice as much insulin, I'd still pay the same. So I have no problem just throwing away a nearly full pen or vial. I'd rather have assurance that my insulin will work when I need it. And I often carry my humalog pen all over, with less than ideal assurance that I've kept it at "room temperature." I know I've burned my pens before. And basal insulin's like Lantus are even more fragile.
The best I can tell, the manufacturers did studies of how well the insulin stood up to worst case conditions over the time, and pretty much across the board, we have the same stated storage and in-use claims. Refrigerated, insulins are good through the expiration date, often up to 2 years. Once started, vials or pens can be kept safely at room temperature for 28 days.
So what does this mean? That the testing showed that the insulin stored at like the warmest temperature was "always" fine at 28 days. If didn't show it failed on day 29, but the manufacturer makes no claim after that. If you search, you will find of other discussions, like Clare's. A detailed discussion of what the insulin manufacturers say on the topic can be found in this editorial in Diabetes Care.
ps. And don't forget BSC's Top Ten Indications You Insulin Has Gone BAD!
thanks bsc! for all this information. I'm going to read all of it.
I still have one of the novolog pens half full, I think I may try it again, I have a feeling from something someone wrote in Clare's post that it was my lantus that may have not been working.
I pay a copay only too but it's not cheap and I guess I feel bad to waste something like this. I don't do the clearing out of 1-2 units except when I'm starting the pen/pen refill so I guess I'm using even less that way too. You're right though it's not a good idea to use half good insulin of course.
I was reading about one insulin, maybe humalog- I can't remember now, that lasts for 45 days, but I'm not sure if that one would be right for me, so I think transferring half of my 300 ml refill to an empty vial and storing that in the fridge might work for me.
I guess with syringes you don't waste as much maybe and you can get a smaller dose for corrections which I would prefer, but I really prefer pens overall- I only did the syringe once in the hospital when they were showing me how to do it and I had a hard time with it since the needle is longer and it was very awkward.
I know that you think you are wasting units by priming, but if you are dosing small boluses and need 1/2 unit accuracy, you really should prime. If you don't prime, then much of the first unit will simply go towards filling the needle. This results in an innaccurate and highly variable dose.
To assure yourself of this, just test it. Get a glass plate, put on a new needle, dial in a 1 unit dose and inject it slowly into a drop on the plate. Now dial in another 1 unit dose and inject it next to the first drop. Are they a different size? Did you even get any insulin in the first drop?
ps. I think all insulin expires after 28-30 days once you open. I use Humalog and it is 28 days.
I agree completely bsc I always prime before I shoot up (sorry inject)
thanks bsc, I'm going to try that. I wonder if I have been using lower doses and haven't even realized it... I guess that would mean I'm still producing my own insulin too, which I had other signs of also, and or the new diet is helping a lot more than I realized. I will let you know my results.
It has also been a matter of time as it takes so long to do all this stuff so priming takes that extra bit of time too. I notice after an injection that insulin just keeps coming out of the needles in little beads/drops.
My endo had said it isn't really necessary to prime every time but I was using much larger doses then and I guess it makes less of a difference that way.
I think he said to prime with 2 units, do you use only 1?
I always use 2 units, and the insulin still leaking out of the pen needle after you pull it out of your skin is because you may not be leaving the needle in long enough. The instructions say to leave it in for 5 seconds or so after you have pushed the plunger all the way in.
I'm not sure what is going on with that, because this happens every time I do it, a little bead of insulin usually until I take the needle off- I have a disposable container and twist it off. I do leave the pen in with the plunger depressed, usually for 20 seconds with a larger dose and 10 seconds or more for smaller doses. on a few occasions it did seem like a lot more dripped out so something must have gone wrong those times- maybe I had it at an angle. I usually do the basal dose in my back and it is hard to see what angle your'e at and everything else in the stomach which is so much easier to see what is going on... that has never happened with that site. when a lot spilled out I increased the dose a bit just in case.