How long out of the fridge?

[everydayupsanddowns]

Following on from Ollie's 'how can you tell if insulin is denatured' thread: http://www.diabetessupport.co.uk/boards/showthread.php?t=21849

I have had *another* time where a few days of slightly higher BGs have rapidly worsened on one day and then locked right back into range once a new cartridge of insulin was installed.

It's very hard to be absolutely sure, because of all the variables constantly in play, but over the last 6 months or so I've had a few of these. Who knows... over the previous years where I wasn't watching as closely maybe I've had many more.

Just wondering if anyone uses any kind of method/marker or mechanism for noting down the date when they begin a new cartridge, pen or vial so that they can make sure it has not been in use out of the fridge for longer than the recommended time.

At current rate (including airshots) one lantus cart *should* last me 20 days, so in theory there should be no problem... but it certainly seemed like my basal ran out of legs over the last 48 hours.

 

[FM001]

As I said on Ollies thread, if bg readings are running high despite giving the correct dose for the previous meal and is failing to fall despite corrections then it's best to change the insulin, poor absorption in overused injection sites can result in higher bg as well as illness but if these are ruled out then I always swap everytime.

edit to say I don't note note down when I change a cartridge as I change both insulin's once a fortnight when they run out.

 

[Northerner]

A lantus cartridge lasts me longer than a month, or rather it would if I didn't remember to change it after 28 days! I write in my BG diary when I put a new cartridge in and if I think I'm getting close to expiry then check back. 🙂

 

[everydayupsanddowns]

Yes it's odd isn't it Toby... There are so many variables that insulin going 'off' hasn't really been on my radar very much, but co-incidentally the very ends of more than one cart over the last 6 months have coincided with some unusual readings and it's got me thinking.

Could mark it on the calendar I suppose (but then I'd never check that). Or put a little paper sticker on the pen and write the start date on...

But then the infrequency of it seeming to make any difference means that just observing for a few days 'to see what happens' might be the best bet. I still don;t like having to sit through those few days though.

 

[everydayupsanddowns]

A lantus cartridge lasts me longer than a month, or rather it would if I didn't remember to change it after 28 days! I write in my BG diary when I put a new cartridge in and if I think I'm getting close to expiry then check back. 🙂

Ah the benefits of a manual log... Since using the Expert, I don't manually log everything these days unless I suspect "something's up" or I'm coming up to a review, and there's no way of adding those kind of details on the Expert.

I guess when I start on the pump I'll be double-entry logging for the first few months at least.

 

[Hanmillmum]

I try to stick to the 1st day of the month when changing the pen cartridge we keep for back up in Millie's bag. Very rarely gets used so need a system.🙂

 

[FM001]

Could mark it on the calendar I suppose (but then I'd never check that). Or put a little paper sticker on the pen and write the start date on...

Insulin going off aside, why do you need to write down when you change a cartridge, is it because one can last longer than 28 days?

 

[imtrying]

I just work on the assumption I inject so much I'd be changing it before 28 days!

 

[Vicsetter]

Use a permanent marker (or CD marker) pen and write the use before date on the pen when you take it out of the fridge (saves having to calculate each time you use it).

 

[everydayupsanddowns]

Insulin going off aside, why do you need to write down when you change a cartridge, is it because one can last longer than 28 days?

Just to know how long it had been 'in use' and out of the fridge really. A bit like checking the 'best before' on bread to know how closely you should look for bits of mould developing...

 

[MeanMom]

Levimir never gets a chance to go past its 'best before' date in this house as one refill only lasts about a fortnight😱
However I think it could become less effective if it was kept to warm(or cold) on a regular basis Its surprising how warm a pocket can get or a bag in a centally heated room. K keeps both types of insulin in a Frio wallet (each) all year round just to be on the safe side.
Also(as I think someone else mentipned) we have noticed the difference immediately when the DSN told K she was to stop injecting her Levimir into the same place in her arms(was getting lumpy) and to inject Levimir always into legs
But if in doubt chuck it out!

 

[margie]

I think the rate at which the insulin degrades is related to the temperature. The greater the temperature the faster the degradation. If your pens have been in a hot car for a long period or maybe your PC fan has been blasting hot air maybe that has had an affect.

 

[FM001]

Just to know how long it had been 'in use' and out of the fridge really. A bit like checking the 'best before' on bread to know how closely you should look for bits of mould developing...

I see your reasoning. In some respects writing the date down would be handy if like Northerner a cartridge lasts longer than 4 weeks, another example could be if someone has a pen at home and work for their bolus injections, having two pens could inevitably mean that the work pen could expire for someone working a 5 day week.

 

[everydayupsanddowns]

Use a permanent marker (or CD marker) pen and write the use before date on the pen when you take it out of the fridge (saves having to calculate each time you use it).

Great idea for disposable pens Vicsetter. I've always used refills so I guess a paper sticker would be the way forward. Having said that it's not long before I'll be on vials, so I may just be able to mark them on the label.