Hi everyone, ive had t1 diabetes for only 1 month now. I am almost through my first pens of long and fast acting insulin and was told by my doctor I have to throw it out after 28 days. There is still about a 1/4 of each pen left and I dont want to waste it. I do have more of both kept in the refrige
I don't think there's anything dangerous about using old insulin, but it mag decrease in effectiveness so you'll probably find that you need more (but it's difficult to predict how much more)
Does it really decrease in effectiveness after the 28 days or does that happen after weeks/months of it being old?
It's a combination of time and temperature. Insulin is a protein and protein degrades over time. The higher the temperature, the faster it degrades. The longer it's out at room temperature, the more it has degraded. It basically degrades very very slowly in the fridge because the cold acts as a preservative but it has an expiration date for the same reason: with enough time, even at fridge temperatures, the protein degrades enough to where it's not as effective anymore. At room temperature, that process is just accelerated.
The tl;dr is that the manufacturers can only guarantee that it remains at the same efficacy it would be in the fridge, but at room temperature, for about 28 days. After that, they can't guarantee it anymore. It doesn't mean the insulin has suddenly gone bad, but with
Unfortunately its not free for me, although with my coverage I only paid $50 cad for 5 pens of each, so at this rate about $10/ month in insulin so not too bad. I also paid only $40 for 2.5 months worth of CGMs
I’ve never paid attention to the 28 day rule. I think drug companies want that short on purpose
I've used insulin that was months old when I found a bottle misplaced in the house multiple times. Insulin is good at room temperature for way longer than the "official guidance"
It's not going to hurt you, absolutely worse case scenario it doesn't work as well as usual.
If it were me, I would just use them till empty
Yes on the 29th day it suddenly drops to zero. /s
Very helpful, thanks
Here is a cochrane review from 2023 that says insulin lasts much longer, like months, at room temp than previously thought. https://www.cochrane.org/about-us/news/human-insulin-less-temperature-sensitive-previously-thought
I don't count how many days I've had mine out of the fridge honestly. How many units of each do you use daily? I've been more insulin resistant lately so it doesn't bother me. But yeah normally you would have to throw them out. But you can still try them after 28 days and track you sugars, see what effects it does have. Worst case scenario, when a pen is slightly old you can increase your dosage.
I take 8 units of long acting daily and 4 units of fast with each meal. I'm new to all of this and haven't been given a sliding scale for carb to insulin ratios. Hoping they do it with me on the 9th for my appointment, as they are having me track food, insulin dosages and glucose for 3 days before appointment. I dont always take the full 4 units of fast unless my meal is carb heavy as ive noticed it has been causing lows about 2 hours after meals if it not carb heavy
I also didn't need much insulin at the beginning. Maybe you could still take the 4 units after 28 days, but the insulin would be less effective, so your bg would be ok. Important thing I've learned since my diagnosis 2 years ago, this disease is really more of a "go with the flow" kinda thing. Try things on your own. Don't let doctors dictate your life, they don't see the daily effects it has for you. Try something, and if it doesn't work, try something else. And you should definitely ask for your ratios. Dont wait for them. Take control, trust me. You got this 💪
Kind of been doing that already considering I haven't seen a endocrinologist yet and was just prescribed the 8 long daily and 4 fast with every meal. If i have a light lunch and some snacks in between dinner my glucose stays pretty level that way instead of taking insulin.
I'm still new to this but seems like im more insulin resistant in the morning and sensitive in the evening. So I take the full 4 for my breakfast and it still spikes up to 10mmol sometimes. But right now im In a 5 day stretch of being 100% in range so think im doing ok. Over christmas I did indulge a little bit and spike up to 15 mmol
I will just point out that, according to the manufacturer's patient information, you are supposed to perform a "safety check" (Lantus) or "prime" the pen (Humalog) where you dial 2 units and then inject into the air.
If you were doing that, then your long-lasting insulin should last 30 days and the fast-acting should last no more than 25 days (assuming only two meals per day)
I was curious about that as i have seen it online. I have basaglar and admelog. The pharmacist did tell me to do that only once when the pen is new and said i dont have to do it everytime. And yes mostly have been taking 2 doses of the fast acting daily with my breakfast and dinner 4 units each.
I personally have not had a fast acting insulin pen last 28 days. But, I am very familiar with tossing 1/2 a vial of Lantus/Semglee out every 28 days. The same rule applies for pens. Yes! Chuck the pens after 28 days of use.
The instructions say to toss 28 days after opening, and with my more than a decade of using the Lantus/Semglee vials, I find that the 28 day rule is pretty spot on. I have tried to make the vial go beyond 28 days, but notice an all day rise in glucose levels between days 30-32.
My current basal pens only last 27 days, so I don't need to worry about it, but I do track it all the same.
As for cold insulin, it stings a little. You can do it, but I am finding it more comfortable using room temperature insulin these days.
I take mine until it’s done. And (I know this is going to sound bad) I’ve used reallllllllyyyyy old vials (years) that have been in an old purse for short acting and they were just fine.
I keep my insulin in the fridge for months…even years. When I was on pens, I did not use all my long in a month. I never had a problem.
This research paper has shown that insulin is effective for up to 12 weeks of room temperature. As long as it is not cloudy or has particulates - I’d use it.
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD015385.pub2/abstract
You are new to this so be careful with my advice.
They say 28 days because they are certain it'll still be like new at 28 days. I'd expect it'll be like new at 40 days and then only slowly lose potency. I've been T1 a long time and I've experimented quite a bit using insulin's that I wouldn't suggest a new person use and they always take more abuse than you'd think. I wouldn't worry at all about using it for a 5th week.
Ya im not looking to stretch it another month or 2, just a week or something so its not wasting so much
I wouldn't worry at all about stretching it out for another week or 2
Nonsense. It doesn't lose effect that fast unless you store it in the hot sun.
Keep your active pen in the fridge. You probably visit there several times a day.
I've considered keeping it in the fridge, but doctor told me it hurts a bit to inject cold insulin. Probably nothing I couldn't handle but just made me a bit nervous about cold insulin haha
I don't feel even cold insulin. I really feel it when I poke a nerve.. nothing is that bad.
If anything it may sting briefly, but the feeling is gone as fast as it came.
Eh, it can sting a little but most of the time it doesn't. For me its worth the peace of mind to not have to count days and keep track of how long it has been out. Just leave it in the fridge.
I was told one month out of the fridge (30/31 days). I've had some luck with using older insulin, but the one time I was hospitalized with high blood sugar was because I was using old insulin. Personally, I would continue to use it while keeping a closer eye on my blood sugar, and if it's going higher than it should based on how much you took, toss it. And don't do what I did and give yourself a lot of extra insulin to try to make it work, it didn't help at all, I should have swapped to one I knew was good after the first two shots did nothing.
I have been a diabetic 1 for 4 yrs and I have never quit using a pen after 28 days and didn’t notice any difference in strength.
Seems like you have a great control for now. I also spiked to 16 mmol at Christmas, lol. Win some, lose some. We have to give ourselves grace.
The manufacturer recommendations seem to be based on previous generations of insulin which weren't as stable. In practice, I've noticed no decline in effectiveness at normal room temperatures after about a year. Haven't had any sit around longer than that so far.
You might find this interesting: https://forum.fudiabetes.org/t/the-great-unrefrigerated-expired-insulin-demo/5132
Personally, i keep 1 pen out the fridge at all times (i’m on a pump) until it’s completely used up then open a new one.
My doc said insulin can last in the fridge up to 3 months
Consider an insulin pump….it will use fast acting insulin that has a two year expiration date.
the 28 days is when they are left outside in the room, I have a few months supply in the fridge and they work just fine.
look on your boxes and see the production date and use by date
I end up throwing away more then half. I notice that the potency of the insulin seems to drop, at times I need additional shot.
When I was new to insulin, I hated throwing pens away too. I learned to mark the start date and always check for cloudiness or unusual color. For me, using a pen a little past 28 days felt fine, but I never risked anything that looked off.
Pump user have backup set of glargine insulin pens for emergency. The pens live in the refrigerator. Mine are over 2 years old. Used only once with novalog injections (syringes) for boluses.
How long do insulin pens last if stored in the refrigerator?
you need to keep them in the fridge all the time. and they will last for many months until the expiry written on them
That’s not all… (4) CGM sensors only last 28 days (under best circumstances).